Sutureless anastomotic devices present several advantages over traditional suture anastomosis,including expanded global access to microvascular surgery,shorter operation and ischemic times,and reduced costs.However,th...Sutureless anastomotic devices present several advantages over traditional suture anastomosis,including expanded global access to microvascular surgery,shorter operation and ischemic times,and reduced costs.However,their adaptation for arterial use remains a challenge.This review aims to provide a comprehensive overview of sutureless anastomotic approaches that are either FDA-approved or under investigation.These approaches include extraluminal couplers,intraluminal devices,and methods assisted by lasers or vacuums,with a particular emphasis on tissue adhesives.We analyze these devices for artery compatibility,material composition,potential for intimal damage,risks of thrombosis and restenosis,and complications arising from their deployment and maintenance.Additionally,we discuss the challenges faced in the development and clinical application of sutureless anastomotic techniques.Ideally,a sutureless anastomotic device or technique should eliminate the need for vessel eversion,mitigate thrombosis through either biodegradation or the release of antithrombotic drugs,and be easily deployable for broad use.The transformative potential of sutureless anastomotic approaches in microvascular surgery highlights the necessity for ongoing innovation to expand their applications and maximize their benefits.展开更多
基金funding support received from the Institute of Materials Science and Engineering,and the Institute of Clinical and Translational Sciences grant UL1TR002345 from the National Center for Advancing Translational Sciences of the NIH,DoD Peer Reviewed Medical Research Program Discovery Award(HT94252310022 to Li and Sacks)Traumatic Brain Injury and Psychological Health Research Program Idea Development Award(W81XWH-22-1-0785 to Li),and NIH R01HL168513(Li).
文摘Sutureless anastomotic devices present several advantages over traditional suture anastomosis,including expanded global access to microvascular surgery,shorter operation and ischemic times,and reduced costs.However,their adaptation for arterial use remains a challenge.This review aims to provide a comprehensive overview of sutureless anastomotic approaches that are either FDA-approved or under investigation.These approaches include extraluminal couplers,intraluminal devices,and methods assisted by lasers or vacuums,with a particular emphasis on tissue adhesives.We analyze these devices for artery compatibility,material composition,potential for intimal damage,risks of thrombosis and restenosis,and complications arising from their deployment and maintenance.Additionally,we discuss the challenges faced in the development and clinical application of sutureless anastomotic techniques.Ideally,a sutureless anastomotic device or technique should eliminate the need for vessel eversion,mitigate thrombosis through either biodegradation or the release of antithrombotic drugs,and be easily deployable for broad use.The transformative potential of sutureless anastomotic approaches in microvascular surgery highlights the necessity for ongoing innovation to expand their applications and maximize their benefits.
