Side-to-side sutureless vascular anastomosis with magnets

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Presentation transcript:

Side-to-side sutureless vascular anastomosis with magnets Detlev Erdmann, MD, PhD, Ranya Sweis, MD, Christoph Heitmann, MD, Koji Yasui, MD, Kevin C. Olbrich, PhD, L.Scott Levin, MD, A.Adam Sharkawy, PhD, Bruce Klitzman, PhD Journal of Vascular Surgery Volume 40, Issue 3, Pages 505-511 (September 2004) DOI: 10.1016/j.jvs.2004.05.026

Fig 1 Magnetic vascular positioner magnets on a plastic pedestal. Journal of Vascular Surgery 2004 40, 505-511DOI: (10.1016/j.jvs.2004.05.026)

Fig 2 Scanning electron micrographs of magnet. A, Wide field micrograph (20×). B, Medium magnification (80×) of area indicated by small box in A. C, High magnification (640×) of area indicated by small box in B. Note gross distortion of image at the poles (heel and toe) of the magnets, but little apparent distortion along the sides. Journal of Vascular Surgery 2004 40, 505-511DOI: (10.1016/j.jvs.2004.05.026)

Fig 3 Schema of the side-to-side anastomosing of the artery and vein. A, Insertion of the intravascular magnet. The extravascular magnet is held at some distance from the intravascular magnet to prevent premature attraction. B, Alignment of the intravascular and extravascular magnets. C, Release of the extravascular magnet onto the intravascular magnet. D, Alignment of the venous pair of magnets above the arterial pair of magnets. E, Self-alignment and attraction of the 4 magnets, completing the anastomosis. Journal of Vascular Surgery 2004 40, 505-511DOI: (10.1016/j.jvs.2004.05.026)

Fig 4 Scanning electron micrographs of luminal surface of explanted artery. Note cobblestone appearance of the surface, indicating endothelial cell coverage. Journal of Vascular Surgery 2004 40, 505-511DOI: (10.1016/j.jvs.2004.05.026)

Fig 5 A, Wide field photo of the short-term completed arteriovenous anastomosis, with magnets (arrow) visible between the vein (above) and the artery (below). B to D, Macro photographs of the 10-week explanted anastomosis, with magnets clearly visible from the luminal side. B, Low magnification view from the arterial lumen. C, View of a typical anastomosis from the luminal side. D, View of the anastomosis with the highest measured hydrodynamic resistance from the luminal side. Note the smaller lumen compared with that in C. Journal of Vascular Surgery 2004 40, 505-511DOI: (10.1016/j.jvs.2004.05.026)

Fig 6 Comparison of vessel wall thickness of long-term (solid bars) and short-term (open bars) grafts at both the proximal and distal positions. *P < .05, long-term vs short-term grafts. Journal of Vascular Surgery 2004 40, 505-511DOI: (10.1016/j.jvs.2004.05.026)