Efficacy, Efficiency, and Safety of a Poly-L-lactic Acid Cuff Tube Assisting for Microvascular Anastomosis.

BACKGROUND

Vascular anastomosis is a cornerstone of microsurgery. Anastomosis time and vessel patency significantly influence surgical success. The disadvantages of the traditional hand-sewn method requires a high technical threshold, prolonged surgical time, and an increased risk of vessel occlusion or leakage. Consequently, developing a reliable device to facilitate vascular anastomosis is essential in microsurgery.

METHODS

In this study, a poly-L-lactic acid (PLLA) cuff tube with favorable mechanical and biological properties was employed for anastomosis using a nonsuture cuff technique. Its biocompatibility was comprehensively evaluated in vitro. Its surgical feasibility was validated in vivo using a rat syngeneic orthotopic hindlimb transplantation model. Vessel patency and anastomotic time were documented, and histopathological analysis was performed.

RESULTS

Both L929 cells viability assay and mammalian chromosomal aberration test showed that the PLLA cuff tubes were noncytotoxic. The mean time of anastomosing a single vessel was 18.9 min using the cuff tube compared with 28.8 min using the hand-sewn method. All vessels remained patent in the cuff technique group, while 3 cases of total occlusion occurred in the hand-sewn group. Histopathological analysis revealed no obvious signs of inflammation or immune response associated with PLLA cuff tube implantation.

CONCLUSIONS

PLLA cuff tube is a safe and effective alternative to traditional hand-sewn method, with strong potential for clinical application in microvascular anastomosis.