ABSTRACT
Background: The conventional technique of microvascular anastomosis may cause trauma
to the vessel wall. In addition, the technique is difficult for beginners and is time
consuming. The duration of ischemia is an important limiting factor for muscle transfer.
In the case of multiple-digit replantations, fatigue developed in the surgeon may
also result in suboptimal results. This study was performed to establish an easier
and shorter method of microvascular anastomosis using the Arista hemostatic agent.
Methods: In this study, 20 carotid arteries obtained from rats were equally divided
into two groups. The arteries were then divided and repaired using three simple interrupted
stay sutures with Arista powder. Evaluations were performed using the following three
methods: (1) clamping time during the vessel anastomosis, (2) patency test (after
1 hour, 24 hours, and 28 days), and (3) light microscopic findings. Results: The clamping
time in the conventional suture anastomosis group was 21 ± 4 minutes, whereas that
of the minimal suture in the Arista group was 12 ± 2 minutes; the difference between
the two groups was statistically significant (P < .001). There was no significant difference between the patency rates of the two
groups (P = .474). It was observed that the Arista group showed qualitatively less perivascular
foreign-body giant cell reaction than the control group. There was no evidence of
vascular mural fibrinoid necrosis, indicating that Arista was nontoxic for the vessel
walls. Conclusions: The Arista-assisted microvascular anastomosis is an alternative
to the conventional suture-only method because it reduces the anastomosis time significantly
and does not cause narrowing of the vessel wall. We believe that this technique has
the potential for improving the performance of microvascular anastomosis in clinical
practice.
KEYWORDS
Microvascular anastomosis - Arista
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Erol BenlierM.D.
Trakya Üniversitesi Tip Fakültesi, Plastik
Rekonstrüktif ve Estetik Cerrahi AD, Edirne 22030, Turkey
