Experimental study of a novel mechanical connector for sutureless open arterial anastomosis Salam Abou Taam, MD, Jean-François Garbé, MD, Mourad Boufi,

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Presentation transcript:

Experimental study of a novel mechanical connector for sutureless open arterial anastomosis Salam Abou Taam, MD, Jean-François Garbé, MD, Mourad Boufi, MD, PhD, Jean-Pierre Bossavy, MD, PhD, Jean-Baptiste Ricco, MD, PhD Journal of Vascular Surgery Volume 55, Issue 1, Pages 210-215 (January 2012) DOI: 10.1016/j.jvs.2011.07.082 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Drawing shows the sutureless device implanted in the artery. The assembly consists of a connector made of a bare-metal stent with spikes covering its outer surface. The seal of the anastomosis is obtained by balloon inflation to anchor the stent, with the help of spikes that penetrate the prosthesis and the arterial wall. B, Drawing the bare-stent with spikes shows the project. C, Picture of the bare stent completed with the spikes. Journal of Vascular Surgery 2012 55, 210-215DOI: (10.1016/j.jvs.2011.07.082) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Implantation of the device in the pig aorta. A, Operative view of the sutureless anastomosis being completed with the aorta clamped. B, Completion angiography of the aortic graft with the spiked stent in place and the distal handmade anastomosis on the aortic bifurcation. C, Picture of the anastomotic device inserted into the prosthetic graft and introduced into a 20F sheath before aortic implantation. Journal of Vascular Surgery 2012 55, 210-215DOI: (10.1016/j.jvs.2011.07.082) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 In vitro tests for tensile strength quantified in Newtons (N). The median force needed to rupture the automated anastomoses was 18.3 N, with no significant difference with that needed to disrupt the sutured anastomoses (19.5 N, Mann-Whitney U test, P = .33). Journal of Vascular Surgery 2012 55, 210-215DOI: (10.1016/j.jvs.2011.07.082) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 In vivo experiments in seven pigs with the time for completion of the anastomoses. The median anastomosis time using the sutureless device was 2.4 minutes (interquartile range [IQR], 1.4-3.3 minutes), which was significantly shorter than the 17 minutes (IQR, 15.1-17.2 min) required for the sutured aortic anastomosis in the same animals (Mann-Whitney U test, P = .002). Journal of Vascular Surgery 2012 55, 210-215DOI: (10.1016/j.jvs.2011.07.082) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 5 A, Longitudinal section of the explanted pig aorta is shown at 4 weeks, with the automated anastomosis (upper part) and the sutured anastomosis (lower part). The distance between the two green arrows represents the length of the bare stent within the aorta. B, Details of the telescoping anastomosis shows the full length of the stent anchoring the prosthesis in the aortic wall. The 5-mm distance between the two red arrows represents the length of the bare stent within the aorta. C, Photomicrograph of the pig aorta shows the phantom of a spike penetrating the aortic wall with a normal wall architecture and no intimal hyperplasia. Journal of Vascular Surgery 2012 55, 210-215DOI: (10.1016/j.jvs.2011.07.082) Copyright © 2012 Society for Vascular Surgery Terms and Conditions