TY - JOUR
T1 - Sutureless microvascular anastomosis assisted by an expandable shape-memory alloy stent
AU - Saegusa, Noriko
AU - Sarukawa, Shunji
AU - Ohta, Kunihiro
AU - Takamatsu, Kensuke
AU - Watanabe, Mitsuhiro
AU - Sugino, Takashi
AU - Nakagawa, Masahiro
AU - Akiyama, Yasuto
AU - Kusuhara, Masatoshi
AU - Kishi, Kazuo
AU - Inoue, Keita
N1 - Funding Information:
N.S. was supported by a scholarship from Keio University. N.S., S.S., K.O., K.T., M.N., and K.I. were supported by the Kanto Bureau of Economy, Trade and Industry ?Problem Solving Type Project for Development of Medical Devices, #20140422-Kanto-7? and ?Strategic Support Project for Core Technologies (Support Industry Project), #20150901-Kanto-93?. URL: http://www. kanto.meti.go.jp/data/english/index.html. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funder provided support in the form of salaries for authors N.S., S.S., K.O., K.T., M.N., and K.I., but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ?author contributions? section. The authors would like to thank Pharma Valley Center of Shizuoka prefecture for assistance and coordination of the research project. The authors would also like to thank colleagues in the Immunotherapy Division of Shizuoka Cancer Research Institute for help with ex vivo experiments, and Dr. Koji Maruyama and his colleagues for assistance with animal experiments.
Publisher Copyright:
© 2017 Saegusa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/7
Y1 - 2017/7
N2 - Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5–10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology. In the present study, we designed a bare metal stent, Microstent, that was constructed by laser machining of a shape-memory alloy, NiTi. An end-to-end microvascular anastomosis was performed in SD rats by placing the Microstent at the anastomotic site and gluing the junction. The operation time for the anastomosis was significantly shortened using Microstent. Thrombus formation, patency rate, and blood vessel strength in the Microstent anastomosis were superior or comparable to hand-sewn anastomosis. The results demonstrated the safety and effectiveness, as well as the operability, of the new method, suggesting its great benefit for surgeons by simplifying the technique for microvascular anastomosis.
AB - Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5–10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology. In the present study, we designed a bare metal stent, Microstent, that was constructed by laser machining of a shape-memory alloy, NiTi. An end-to-end microvascular anastomosis was performed in SD rats by placing the Microstent at the anastomotic site and gluing the junction. The operation time for the anastomosis was significantly shortened using Microstent. Thrombus formation, patency rate, and blood vessel strength in the Microstent anastomosis were superior or comparable to hand-sewn anastomosis. The results demonstrated the safety and effectiveness, as well as the operability, of the new method, suggesting its great benefit for surgeons by simplifying the technique for microvascular anastomosis.
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U2 - 10.1371/journal.pone.0181520
DO - 10.1371/journal.pone.0181520
M3 - Article
C2 - 28742116
AN - SCOPUS:85025149582
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 7
M1 - e0181520
ER -