[Nonsuture microvascular anastomosis--experimental arterial end-to-end anastomosis using plastic adhesive and a soluble PVA tube (author's transl)].

Microvascular anastomosis is now widely applied and many improved methods of the nonsuture anastomosis have been developed instead of the suture anastomosis for the purpose of saving time and making the reconstruction easier. We introduced a new nonsuture method of microvascular anastomosis using plastic adhesive and a soluble tube made of polyvinylalcohol (PVA). PVA, which had been utilized as a plasma expander, is a water-soluble polymer and its solubility is changeable depending on the degree of polimerization and percent saponification. We have made two kinds of soluble PVA tubes, the one has monolayer wall and the other double layered wall. The inner wall of the latter is more soluble than the outer wall. As plastic adhesives, we employed ethyl 2--cyanoacrylate, isopropyl 2--cyanoacrylate, and isobutyl 2--cyanoacrylate which were much superior to methyl 2--cyanoacrylate. Common carotid arteries of rats of 1.0 to 1.3 mm external diameter range were reconstructed and re-exploration was carried out at intervals of more than 7 days after operation. The anastomotic technique was very easy and it took about five minutes to reconstruct. In our last series, approximately 98 percent patency rate was achieved. The advantage of our method is that the blood stream is regained in the small soluble at the anastomotic site immediately after the release of hemostatic clamps.