Effect of arterial adventitial stripping methods on patency and thrombus formation at microvascular anastomoses

Oh, Hee Kyun; Lee, Yong Uk; Ryu, Seong Hee; Seo, Il Young; Park, Hong Ju; Kim, Sun Hun; Choi, Jeong Hee

Abstract

The purpose of this study was to evaluate the effect of adventitial stripping methods on patency and thrombus formation at microvascular anastomoses in the femoral artery of rabbits. The experimental animals were divided into 3 groups according to stripping methods: In Control group, arterial adventitia was not stripped at microvascular anastomoses (n=4); in Sharp stripping group, adventitia stripped by sharp stripping method using microscissors and Jeweler's forceps (n=4); and in Blunt stripping group, adventitia stripped by blunt stripping using two Jeweler's forceps (n=4). The patency was evaluated by empty-and-refill test immediately, 30 minutes and 3 days after microvascular anastomoses. Thrombus formation was evaluated by the microscopic examination 3 days after microvascular anastomoses and the histological examination was done around the anastomosed site. Thirty minutes after microanastomoses, the patency of both Sharp and Blunt stripping groups was better than that of Control group, but there was no statistically significant difference in patency among 3 groups. Three days after microanastomoses, the patency of both Sharp and Blunt stripping group was better than that of Control group (P<0.05) and there was no statistically significant difference between Sharp and Blunt stripping groups. Compared with 30 minutes after anastomoses, the patency of Sharp stripping group was still good 3 days after anastomoses, but the patency of Blunt stripping was slightly decreased and that of Control group was worst among groups. Three days after microanastomoses, the amount of thrombus in both Sharp and Blunt stripping groups was less than in Control group (P<0.05) and there was no statistically significant difference between Sharp and Blunt stripping groups. In histologic examination, the amount of thrombus in the lumen and the ingrowth of adventitia into the lumen in Sharp and Blunt stripping groups were less than that in Control group (P<0.05) and there was no statistically significant difference between Sharp and Blunt stripping groups. In conclusion, these results suggest that arterial stripping is effective in microvascular anastomoses and the sharp stripping method is better than the blunt stripping method.