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Does vascular stapling improve compliance of vascular anastomoses?

机译:血管吻合术能改善血管吻合的顺应性吗?

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Elastic properties of vessel walls are altered by vascular anastomoses. Such alterations may lead to neointimal hyperplasia, which is a common cause of reocclusion following vascular surgery. The severity of paraanastomotic hypercompliant zones and anastomotic compliance drop depend on suturing material and on elastic properties of the anastomotic vessel segments. This study compares paraanastomotic hypercompliance and anastomotic compliance drop when using a new vascular closure system (VCS((R))) and a conventional, continuous suture line in the preparation of end-to-end anastomoses. Compliance of artery-artery, vein-artery, and polytetrafluoroethylene-artery anastomoses was measured in an artificial circulation system at mean pressures of 60, 90, and 120 mm Hg, comparing conventional suturing and the VCS. When using the VCS for vein-artery anastomoses, significantly less postanastomotic hypercompliance was achieved at mean pressures of 60 mm Hg (14.2 +/-3.8% above remote postanastomotic area), compared to suture (55.1 +/-14.8%, p<0.05). At 90 mm Hg, respective values were 11.0 +/-2.3% for VCS and 54.7 +/-10.1% for suture, p<0.01. At 120 mm Hg, in polytetrafluoroethylene-artery anastomoses, the anastomotic compliance drop was significantly less when using the continuous suture line (93.9 +/-1.1% below remote postanastomotic compliance), compared to VCS (97.2 +/-0.2%, p<0.05). Compared to conventional suturing, use of the VCS reduced postanastomotic hypercompliance in vein-artery anastomoses.
机译:血管吻合改变了血管壁的弹性。这种改变可能导致新内膜增生,这是血管外科手术后再次闭塞的常见原因。吻合口旁高吻合区的严重程度和吻合顺应性下降取决于缝合材料和吻合血管段的弹性。这项研究比较了使用新的血管闭合系统(VCS(R))和常规的连续缝合线准备端对端吻合术时的吻合口超顺应性和吻合顺从性下降。与常规缝合和VCS相比,在人工循环系统中以60、90和120 mm Hg的平均压力测量了动脉,静脉和聚四氟乙烯-动脉吻合的顺应性。当使用VCS进行静脉动脉吻合时,与缝合相比,平均压力为60 mm Hg(比远端吻合后区域高14.2 +/- 3.8%)时,吻合后超顺应性明显降低(55.1 +/- 14.8%,p <0.05 )。在90毫米汞柱下,VCS的相应值为11.0 +/- 2.3%,缝线的相应值为54.7 +/- 10.1%,p <0.01。在120 mm Hg下,在聚四氟乙烯-动脉吻合中,与VCS相比,使用连续缝合线时吻合顺从性下降明显更少(比远端吻合后顺应性低93.9 +/- 1.1%)(97.2 +/- 0.2%,p < 0.05)。与常规缝合相比,VCS的使用减少了静脉动脉吻合后的吻合后超顺应性。

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