This study examined the clinical and pathologicalfeatures after a microvascular anastomosis of a ratfemoral artery using four different suture techniques.Sixty Sprage-Dawely rats were divided randomly into 4groups. Fifteen bisected arteries (one from each animal) inGroup I, II, III and IV were sutured with the simpleinterrupted suture, continuous suture, sleeve suture andcuff suture, respectively. The anastomosis times in GroupI, II, III and IV were 28.67, 14.67, 15.47 and 15.93 min,respectively. Immediate bleeding that stopped withoutintervention (grade I) was observed in 67%, 73% and60% of the anastomosed vessels in Groups II, III and IV,respectively, while 60% of the vessels in Group I showedlight bleeding that was inhibited by gentile pressure(grade II). All vessels examined appeared to be patent at 5and 15min after the anastomosis. On the 7th daypostoperatively, the vessels of Group I showed the highestpatency rate (93%) compared with Groups II (67%), III(73%) and IV (87%). Moreover, there were morepronounced pathological changes in Group I than in theother groups. These changes included endothelial loss,endothelial proliferation, degeneration and necrosis of thetunica media. Suture materials surrounded by aninflammatory reaction were also observed. In conclusion,the simple interrupted suture is preferable formicrovascular anastomosis due to its highest patency rate.The other techniques investigated can be good alternativesbecause of their short anastomotic time and moderatepathological changes.
Anastomosis, Surgical/*methods ; Animals ; Femoral Artery/pathology/*surgery/ultrastructure ; Histocytochemistry ; Microscopy, Electron, Scanning ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; *Suture Techniques

OBJECTIVETo observe the effect of perivenous support with autologous pericardium on neointimal thickening in canine vein grafts.

METHODSAn autologous pericardium graft of 7 cm x 4 cm was harvested in right anterolateral thoracotomy. Two equal segments of the jugular vein were transplanted to both sides of the femoral arteries in 12 dogs, and on one side of the vein graft, perivenous support with autologous pericardium was applied. The vein grafts were harvested 2 and 4 weeks after operation and the thickness and area of the neointima calculated using computerized image analysis system. Scanning electron microscopy and PCNA immunohistochemistry were also performed.

RESULTSThe thickness and area of the neointima were significantly greater in the control grafts than in the grafts with perivenous support (P<0.05), and the proliferation of vascular smooth muscle cells in the supported graft was less active (P<0.05). Electron microscopy showed extensive destruction of the endothelium in the control graft, but only slight damage was found in the graft with perivenous support.

CONCLUSIONPerivenous support of the vein graft with autologous pericardium can reduce intimal and medial hyperplasia in the graft.

Animals ; Dogs ; Femoral Artery ; surgery ; Graft Occlusion, Vascular ; prevention & control ; Hyperplasia ; Immunohistochemistry ; Jugular Veins ; pathology ; surgery ; transplantation ; Male ; Microscopy, Electron, Scanning ; Muscle, Smooth, Vascular ; metabolism ; pathology ; ultrastructure ; Pericardium ; transplantation ; Proliferating Cell Nuclear Antigen ; analysis ; Random Allocation ; Tunica Intima ; metabolism ; pathology ; ultrastructure