One-knot microvascular anastomosis. An experimental study in rats.

Experimental microvascular anastomosis using a glutide copolymer (lactide:glycolide, 80:20) as an external splint was undertaken in 33 rats between the carotid artery and the jugular vein. Both vessels were dissected free over a 1-cm length and cut at the cranial end of the dissected part. The carotid artery was then introduced into a glutide pipe-splint. The arterial wall was turned 180 degrees over the edge of the splint. This reflected artery wall and the glutide were covered by the freed-up jugular vein. One stitch was made around the vein, the artery, and the glutide in a manner similar to binding steel wire over a barrel. Thus, the "one-knot anastomosis" was completed. The patency rate at the anastomosed site was 100%, confirmed by angiography in 30 rats and by direct surgery in three. The time required to produce the anastomosis was between 5 and 7 minutes. Light microscopic observation showed that there was no obstruction by thrombus formation at 1 and 5 weeks after the anastomotic surgery. This technique may be clinically applicable for extracranial-intracranial bypass surgery, reconstruction of venous sinuses, and other vascular procedures.