The Experimental Comparision of the Method Using Amniotic Cuff with Tranditional Methods in Microvascular Anastomoses

Recently, microvascular anastomoses has been developed for wide employment in clinical appliance. However, in end-to-end anastomoses of arteries less than 1mm in diameter, the vascular occlusions have been often occured due to suture materal, suture method and aneurysm, thrombosis and infection at the site of repair.

To obtain the more successful microvascuar method and research the histopathology of the vessel wall after repair, We did the experimental comparison of the different methods of microvascular anastomoses in rat femoral artery less than 1mm in diameter.

The experiment was done in 3 different groups. In group 1:6-8 sutures was done. In group 2:6-8 sutures and application of amniotic cuff to the anastomotic site was done. In group 3:4 sutures and application of anastomotic site was done.

The results are summarized as follows.

1) In all each three groups, patency was 90% and thrombosis was 10%.

2) Aneurysm formation was 40% in group 3, 30% in group 1, 2.

3) Infection was 20% in group 2, 3 and the absence in group 1.

4) The histopathology of the microvascular anastomotic site revealed intimal loss, medial necrosis, elastic lamella loss and subintimal hyperplasia in all groups.

5) The histopathologic comparison of the outer surface of the vessel wall in each groups revealed as followed,

(1) group 1 : much neovascularization and a few inflammatory cells.

(2) group 2, 3 : less neovascularization and much inflammatory cells and much fibrosis than group 1.