Scanning electron microscopy in different techniques of microvascular anastomoses: categorization and factors affecting. A descriptive work

Many researchers have investigated microvascular anastomoses by scanning electron microscope (SEM); however, there are neither reports on classifying these anastomotic types according to the SEM results nor about studying the factors that affect these results. Sixty rat femoral arteries were anastomosed using four different techniques: simple interrupted, continuous, sleeve, and autogenous arterial cuff. The anastomotic sites of each group and other two intact femoral arteries were examined by SEM. Intimal disruption and rebuilding of the blood vessel endothelium after microvascular anastomoses depend upon anastomotic time; suture placement, either intra-luminal or extra-luminal; and mechanical factors. Accordingly, the simple interrupted suture technique has the highest degree of intimal disruption and the lowest degree of regeneration, the continuous and cuff anastomoses have better rebuilding with partial neo-endothelial coverage of the cut ends, whereas the sleeve anastomosis has the best regeneration with complete coverage of the cut ends by the new endothelial cells. Presented in the Fifth Congress of the World Society of Reconstructive Microsurgery (WSRM), Athens, Greece, June 2007.