USE OF LONGITUDINAL INVAGINATING MATRIX SUTURES IN MICROARTERIAL SLEEVE ANASTOMOSES

Abstract. A different approach to end in end anastomosis was tested to minimise the undesirable traits of classicand sleeve (telescoping) methods. Our approach aimed to maintain full contact at the level of the anastomosis byusing longitudinal matrix sutures as a new invaginating suture technique in microarterial sleeve anastomosis.Classic end-to-end anastomosis with seven to eight stitches, Lauritzen’s end-in-end anastomosis with fourstitches, and our modified end-in-end anastomosis with two horizontal matrix sutures were made in 10, 20, and 25rat femoral arteries, respectively. Nine, 17, and 18, respectively were patent at early evaluation; and eight, 13, and14 at the time of late evaluation. There was no significant difference in between the patency rates of the groups.Histopathological examination showed large strictures and the formation of intra-luminal organised thrombuswith thin intramural fibrin precipitation in occluded specimens. The longitudinal matrix sutures in the sleeveanastomoses, which passed through all layers of the vascular wall, injured the intima (a vertical rupture) andconstricted the lumen.Key words: microsurgery, microvascular anastomosis, sleeve anastomosis, invaginating matrix suture technique.

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