Received 3 March 2006; accepted 4 October 2006. published online 10 May 2007.
Summary
Background
Performing vascular anastomoses requires complete circumferential access and is time-consuming and technically challenging. The purpose of our study was to assess a sutureless magnetic device for anastomosing vein grafts.
Methods and results
Oval magnets with a lumen were placed in six male foxhounds. The femoral artery was ligated and an 8cm length of femoral vein was harvested and reversed. After a 4mm venotomy or arteriotomy, one magnet was inserted into each vessel lumen and a second magnet was placed outside the vessel but aligned directly over the intraluminal magnet, forming a magnetic port in each vessel. The graft and target vessels were then allowed to self-align and seal, creating a side-to-side anastomosis. Patency was confirmed with duplex Doppler ultrasound scans after 6 and 13 weeks and during explantation after 14 weeks. At that time, the contralateral femoral vein was harvested and an acute graft was created as a control. Macroscopically there was no sign of stenoses or aneurysms. After explant, saline was perfused through all grafts and the hydrodynamic resistance was quantified. There was no significant difference in resistance between the acute and 14-week grafts indicating stenosis. Microscopic examination of 14-week anastomoses showed that all blood-contacting surfaces were well-endothelialised.
Conclusions
The magnetic vascular coupler allowed sutureless anastomoses between blood arteries and veins. This device might prove useful for anastomosis of large and small vessels, as well as for anastomosis or approximation of non-vascular structures such as peripheral nerves, fallopian tubes or ureters.
aKenan Plastic Surgery Research Laboratories and Biomedical Engineering, Duke University Medical Center, Circuit Dr, Research Park 4, Box 3906, Durham NC 27710, USA
bVentrica, Inc., 5055 Brandin Ct, Fremont, CA 94538,USA
Corresponding author. Tel.: +1 919 684 3929.
☆ Ventrica was acquired by Medtronic, Inc., which now controls the rights to this technology.
☆☆ Some data were presented at the Plastic Surgery Research Council in Las Vegas, April, 2003 and some at the Second World Society of Reconstructive Microsurgery, Heidelberg, Germany, June 2003, where it received the ‘Best Basic Science’ paper award.
ABSTRACT