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Comparative Study of Different Combinations of Microvascular Anastomoses in a Rat Model: End-to-End, End-to-Side, and Flow-Through Anastomosis

Miyamoto, Shimpei M.D.; Okazaki, Mutsumi M.D.; Ohura, Norihiko M.D.; Shiraishi, Tomohiro M.D.; Takushima, Akihiko M.D.; Harii, Kiyonori M.D.

Plastic & Reconstructive Surgery: August 2008 - Volume 122 - Issue 2 - pp 449-455
doi: 10.1097/PRS.0b013e31817d62c5
Experimental: Original Articles

Background: This study aimed to compare several microvascular anastomotic techniques by patency rate using a free flap model in rats.

Methods: A microsurgical transfer model of a pectoral skin flap to the cervical region was used. In experiment 1, 120 rats were divided into four groups (n = 30 in each group) depending on the type of microvascular anastomotic technique. For group 1, end-to-end anastomoses were performed for arteries and veins. For group 2, end-to-side anastomoses were performed for arteries and end-to-end anastomoses were performed for veins. For group 3, flow-through anastomoses were performed for arteries and end-to-end anastomoses were performed for veins. For group 4, end-to-end anastomoses were performed for arteries and end-to-side anastomoses were performed for veins. Flap survival was assessed on day 3 and the success rates of the four groups compared. In experiment 2 (n = 10), postoperative blood flows of end-to-end and flow-through arterial anastomoses were measured.

Results: In experiment 1, the success rates in groups 1, 2, 3, and 4 were 76.7, 83.3, 100, and 83.3 percent, respectively. Differences between group 3 and the other groups were statistically significant. In experiment 2, the blood flow of flow-through arterial anastomosis (1.8 ml/minute) was much higher than that of end-to-end anastomosis (0.18 ml/minute).

Conclusions: Flow-through arterial anastomosis presented a higher blood flow through the anastomotic site, resulting in a higher success rate than conventional anastomoses. In veins, end-to-side anastomosis was equivalent to end-to-end anastomosis even though the diameter of the donor vein was larger than the recipient vein.

Tokyo, Japan

From the Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine.

Received for publication October 31, 2007; accepted December 27, 2007.

Disclosure: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.

Shimpei Miyamoto, M.D., Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan, shinpei@kyorin-u.ac.jp

©2008American Society of Plastic Surgeons