Experimental study of sutureless vascular anastomosis with use of glued prosthesis in rabbits

Abstract

Lulzim Vokrri,1–3,5 Arsim Qavdarbasha,1–3 Hajriz Rudari,1–3 Halil Ahmetaj,1–3 Suzana Manxhuka-Kërliu,1–3 Nexhmi Hyseni,1–3 Paolo Porcu,4 Philippe Cinquin,4,5 Carmine Sessa4,6 1Department of Vascular Surgery, University Clinical Center of Kosovo, 2Medical Faculty, University of Pristina, 3Veterinary Institute, Pristina, Republic of Kosovo; 4Department of Vascular Surgery, University Clinical Center of Grenoble, 5University of Grenoble Alpes/CNRS/TIMC-IMAG UMR 5525 (GMCAO team), Grenoble, 38000, 6University of Grenoble Alpes, Grenoble 38000, France Objective: The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits. Methods: Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment. Results: Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (P<5%). There was no significant difference on the average blood flow through the anastomosis between two groups at the end of surgery. All anastomoses with glued prosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses. Conclusion: This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site. Keywords: sutureless vascular anastomosis, polytetrafluoroethylene prosthesis, BioGlue, rabbit aorta