In Vivo Analysis of Dynamic Tensile Stresses at Arterial End-to-end Anastomoses. Influence of Suture-line and Graft on Anastomotic Biomechanics

Objective to determine the influence of an anastomotic suture line and a graft on dynamic tensile stresses of vascular end-to-end anastomoses in vivo. Material and methods the abdominal aorta of twelve 35-kg pigs was used as an experimental model. Simultaneous recordings of internal arterial diamete...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 1999-12, Vol.18 (6), p.515-522
Main Authors: Ulrich, M, Staalsen, N.-H, Djurhuus, C.B, Christensen, T.D, Nygaard, H, Hasenkam, J.M
Format: Article
Language:English
Subjects:
Anastomosis
Anastomosis, Surgical
Animal Model
Animals
Aorta, Abdominal - physiology
Aorta, Abdominal - surgery
Biocompatible Materials
Biomechanical Phenomena
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - instrumentation
Compliance
Elasticity
Graft Patency
Hemodynamics
Hysteresis
Polyurethanes
Stiffness
Suture Techniques - instrumentation
Sutures
Swine
Tensile Strength
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Summary:Objective to determine the influence of an anastomotic suture line and a graft on dynamic tensile stresses of vascular end-to-end anastomoses in vivo. Material and methods the abdominal aorta of twelve 35-kg pigs was used as an experimental model. Simultaneous recordings of internal arterial diameter and pressure were performed on each pig at 3 successive stages: (1) The genuine artery (REF), (2) artery–artery (A-A) and (3) graft–artery (G-A) anastomosis at 1-mm increments in the immediate perianastomotic area. Thereby, RD (relative distension), CC (compliance coefficient), Ep(dynamic pressure-strain elastic modulus) and hysteresis loop areas could be calculated for every measuring point. Results the graft was significantly stiffer than REF. A-A and G-A anastomoses were significantly less compliant than REF. Maximum Ep, minimum CC and hysteresis loop areas were found at the anastomotic line due to minimum anastomotic RD. Downstream of the G-A anastomosis, the RD, CC, Epand loop areas were significantly different from REF, but significantly different from A-A. Conclusion an animal model for acute studies of mechanical properties of vascular end-to-end anastomoses was developed. The main determinant for anastomotic biomechanics was the suture-line itself.
ISSN:1078-5884
1532-2165
DOI:10.1053/ejvs.1999.0937