During the past decade, microsurgery has become clinical routine and resulted in many technical innovations. Inspite of this, microsurgery still entails certain disadvantages; it is time consuming, technically demanding and sometimes results in distressful failure.
The sleeve microanastomosis, proximal vessel end is inserted into distal vessel using only two extraluminal sutures, is easier and less time consuming than conventional end to end anastomosis.
However, there is a few reports about the histological study to support the beneficial technique of the anastomosis.
An animal study was carried out by doing 25 sleeve anastomoses of carotid arteries of white strain rats and subsequent histological observations in different time interval in order to clarify the modesty of repair in anastomosed vessels.
The followings are noted as results;
Patency rate of the anastomosis was 84%.
No aneurysm was found at any site of the anastomosis.
The narrowing of lumen of the inserted proximal vessel, the formation of thrombosis & fibrin clot in foci at proximal vessel end, and the loss of intima at the site of anastomosis were noticed in 3 days following the anastomosis.
Still narrowing of the lumen of inserted vessel, the formation of thrombosis & fibrin clot in foci at proximal vessel end were persisted with focal necrosis of the media at the stitch area of dista Ivessel in one week following anastomosis.
Disappearance of thrombosis & fibrin clot on proximal vessel end and complete restoration
|