The Study Of Quickly Repair The Vascular Defect In Limbs By Vascular Assembly

BackgroundWartime extremity vascular injuries were frequent, contributed to high mortality and disablity rate.The conventional vascular anastomosis method is suturing,which was named "gold standard" vascular anastomosis method.However,the suturing anastomosis has some defects,it's time-consumed and technically difficult,and so on. So many people attempt to seek an ideal vascular anastomosis method.The sutureless vascular bonding method maybe that alternative method,which is still studied in the lab.PurposeTo evaluate the portability,rapidity and feasibility of repairing the vascular defect in limbs by vascular bonding method with self-developed vascular assembly in mongrel dogs,compared with the conventional suturing vascular anastomosis method.MethodA. Establish the proper experimental animal model;Develope the vascular assembly.B. The repairing of vascular defect was performed in vitro by two different methods,one by vascular bonding method with vascular assembly,one by conventional suturing method.Then bursting pressure and tensile strength of the anastomotic site were measured.To evaluate the feasibility of the repair of vascular defect by vascular bonding method with vascular assembly in terms of biodynamics.C. A comparative experimental study was performed in carotid arteries of the mongrel dogs.Incision was made to develope a defect of carotid arteries. One side of carotid artery was anastomosed by vascular bonding mehod with self-devoloped vascular assembly,the other side was end-to-end anastomosed by suturing method.The anastomotic time was noted,the patency condition was examed by imaging test.The vessel speciments were harvested at 8 weeks after operation and were analyzed by light microscope and scanning electron microscope.ResultA. The average diameter of the carotid arteries of adult male mongrel dogs was 4.43±0.056mm,which were weight from 20kg to 25kg.The effective length was 11.69±0.118cm; The average diameter of femoral arteries was 3.99±0.043mm,the effective length was 8.12±0.063cm.B. The tensile strength was 23.50±1.51N in the bonding anstomosis group,compared with 24.60±1.08N in the suturing anastomosis group.Bursting pressure was 52.03±2.43Kpa in the bonding anstomosis group, compared with 50.04±3.51Kpa in the the suturing anastomosis group.There was no statistical difference between the two groups(p>0.05),both pressure-proof and tensile tests confirmed the adequate mechanical strength of the anastomoses.C. It took 15.5±0.55min for the bonding anastomosis with vascular assembly, compared with 25.97±0.58min for suturing anastomosis.Significantly less time was required for the bonding anastomosis than for suturing anastomosis(P<0.01);The immediate patency rates of two groups were both 100%.Imaging test showed patency of the anastomotic site and no sighs of stenosis,blood leakage,or pseudoaneurysm formation in both groups;Macroscopically,smooth luminal surfaces were observed in both groups.Microscopic and electron microscopic examination confirmed intimal healing of the artery to the graft,and there were no hyperplasia.Conclution1,The carotid arteries of adult mongrel dogs are more suitable to the study on large blood vessels than the femoral arteries. 2,It's feasible to repair the defect of large blood vessels by bonding anastomosis with vascular assembly in terms of biodynamics.3,From the preliminary experimental results,the bonding anastomosis with vascular assembly, which was combined with artificial blood vessel,biomebrane and intracascular stent,required significantly less time than the suturing anastomosis. The bonding anastomosis with vascular assembly appears to be a feasible and promising vascular ansatomosis method,which provide a benifical supplement to the suturing anastomosis on repairing the vascular defect in limbs.