Absorbable polydioxanone suture for venous anastomoses: experimental studies using venography and transluminal angioscopy.

Because of their increased tendency to stenosis and spasm and thrombosis, results after venous anastomoses are often unsatisfactory. Nonabsorbable sutures and a continuous suture technique have been suggested to have a negative effect on the compliance of vascular anastomoses. Eighty venous anastomoses were performed with either an interrupted or continuous suture technique, using polypropylene or polydioxanone (PDS) sutures, according to a randomised experimental model. The anastomoses were divided in four groups: (1) Nonabsorbable suture material, continuous suture technique; (2) Nonabsorbable suture material, interrupted suture technique; (3) Absorbable suture material, continuous suture technique; and (4) Absorbable suture material, interrupted suture technique. The morphology of the anastomoses was controlled by venography directly after closure of the wound and at weekly intervals for 2 months and monthly intervals thereafter until 2 years had passed. In 10 cases venography was followed by transluminal angioscopy in the early postoperative period and after 1, 2, 4, 8 and 12 weeks. In the first 2 months moderate and high degree stenoses were found in all 4 groups by venography. After 8 weeks there was a significant decrease in the incidence of stenosis in all groups with the exception of the group, in which continuous nonabsorbable suture had been used. Using angioscopy a marked swelling of the intima at the site of the anastomoses could be detected in the early postoperative period in all experimental groups. After 2 months no significant narrowing could be identified in groups 2, 3 and 4.(ABSTRACT TRUNCATED AT 250 WORDS)