Evaluation of the strength of vascular anastomotic techniques.

The strength of various anastomotic techniques was examined in a canine model utilizing a strain gauge to determine the force required to disrupt single/double/multiple sutures placed at 1,2, and 3 mm depth of bite. Pull-out strength was found to be primarily a factor of the plane of preliminary arterial dissection, reflected as the amount of adventitia included in each bite; the depth of the suture was a lesser contributory factor. Pull-out strengths of complete vascular anastomoses were no stronger than their constituent single stitches. An optimal vascular anastomotic technique is therefore advocated.