Traditional hand-suturing for vascular connection techniques is time consuming, expensive, and requires highly complex instruments and technical expertise. The aim of this study is to develop a new vascular coupler that can be used in end-to-end anastomosis surgery in an easier and more efficient way for both arteries and veins. The vascular coupler has four rotatable wings and one translatable spike in each wing. Prototypes were manufactured using polytetrafluoroethylene (PTFE) and high-density polyethylene (HDPE). A set of installation tools was designed to facilitate the anastomosis process. Proof-of-concept testing with the vascular coupler using plastic tubes and porcine cadaver vessels showed that the coupler should work as designed. A simplified finite element (FE) model assisted in the evaluation of the tearing likelihood of human vessels during installation of the coupler. Results of tests on the coupler showed that the vascular coupler could be efficiently attached to blood vessels, did not leak after the anastomosis was performed, had sufficient joint strength, and had little impact on flow in the vessel. The entire anastomosis process can be completed in 3 min when using the vascular coupler to join porcine cadaver vessels.
Issue Section:
Research Papers
Topics:
Blood vessels,
Design,
Manufacturing,
Testing,
Vessels,
Wings,
Finite element model,
Rotation,
Flow (Dynamics),
Surgery,
Leakage,
Modeling
References
1.
Chang
, K. P.
, Lin
, S. D.
, and Lai
, C. S.
, 2007
, “Clinical Experience of a Microvascular Venous Coupler Device in Free Tissue Transfers
,” Kaohsiung J. Med. Sci.
, 23
(11
), pp. 566
–572
.10.1016/S1607-551X(08)70004-42.
Ross
, D. A.
, Chow
, J. Y.
, Shin
, J.
, and Restifo
, R.
, 2005
, “Arterial Coupling for Microvascular Free Tissue Transfer in Head and Neck Reconstruction
,” Arch. Otolaryngol. Head Neck Surg.
, 131
(10
), pp. 891
–895
.10.1001/archotol.131.10.8913.
Daniel
, R. K.
, Lidman
, D.
, Olding
, M.
, Williams
, J. A.
, and Matlaga
, B. F.
, 1984
, “An Anastomotic Device for Microvascular Surgery
,” Ann. Plast. Surg.
, 13
(5
), pp. 402
–411
.10.1097/00000637-198411000-000084.
Carrel
, A.
, 1902
, “The Operative Technique for Vascular Anastomoses and Transplantation of Viscera
,” Lyon Med.
, 98
(1), pp. 859
–873
.5.
Kleinert
, H. E.
, and Kasdan
, M. L.
, 1963
, “Restoration of Blood Flow in Upper Extremity Injuries
,” J. Trauma Acute Care Surg.
, 3
(5), pp. 461
–476
.10.1097/00005373-196309000-000076.
Yajima
, K.
, Yamamoto
, Y.
, Nohira
, K.
, Shintomi
, Y.
, Blondeel
, P. N.
, Sekido
, M.
, Mol
, W.
, Ueda
, M.
, and Sugihara
, T.
, 2004
, “A New Technique of Microvascular Suturing: The Chopstick Rest Technique
,” Br. J. Plast. Surg.
, 57
(6
), pp. 567
–571
.10.1016/j.bjps.2004.06.0097.
Zdolsek
, J.
, Ledin
, H.
, and Lidman
, D.
, 2005
, “Are Mechanical Microvascular Anastomoses Easier to Learn Than Suture Anastomoses?
” Microsurgery
, 25
(8
), pp. 596
–598
.10.1002/micr.201728.
Andel
, C. J.
, Pistecky
, P. V.
, and Borst
, C.
, 2003
, “Mechanical Properties of Porcine and Human Arteries: Implications for Coronary Anastomotic Connectors
,” Ann. Thorac. Surg.
, 76
(1
), pp. 58
–64
.10.1016/S0003-4975(03)00263-79.
Ferrari
, E.
, Tozzi
, P.
, and von Segesser
, L. K.
, 2007
, “The Vascular Join: A New Sutureless Anastomotic Device to Perform End-to-End Anastomosis. Preliminary Results in an Animal Model
,” Interact. Cardiovasc. Thorac. Surg.
, 6
(1), pp. 5
–8
.10.1510/icvts.2006.13794310.
Filsoufi
, F. R.
, Farivar
, S.
, Aklog
, L.
, Anderson
, C. A.
, Chen
, R. H.
, Lichtenstein
, S.
, Zhang
, J.
, and Adams
, D. H.
, 2004
, “Automated Distal Coronary Bypass With a Novel Magnetic Coupler (MVP System)
,” J. Thorac. Cardiovasc. Surg.
, 127
(1
), pp. 185
–192
.10.1016/j.jtcvs.2003.04.00511.
Gummert
, J. F.
, Opfermann
, U.
, Jacobs
, S.
, Walther
, T.
, Kempfert
, J.
, Mohr
, F. W.
, and Falk
, V.
, 2007
, “Anastomotic Devices for Coronary Artery Bypass Grafting: Technological Options and Potential Pitfalls
,” Comput. Biol. Med.
, 37
(10
), pp. 1384
–1393
.10.1016/j.compbiomed.2006.11.00512.
Jacobs
, S.
, Mohr
, F. W.
, and Falk
, V.
, 2004
, “Facilitated Endoscopic Beating Heart Coronary Bypass Grafting Using Distal Anastomotic Device
,” Int. Congr. Ser.
, 1268
, pp. 809
–812
.10.1016/j.ics.2004.03.27913.
Klima
, U.
, Maringka
, M.
, Bagaev
, E.
, Kirschner
, S.
, and Haverich
, A.
, 2004
, “Total Magnetic Vascular Coupling for Arterial Revascularization
,” J. Thorac. Cardiovasc. Surg.
, 127
(2
), pp. 602
–603
.10.1016/j.jtcvs.2003.09.05014.
Lally
, C.
, Reid
, A. J.
, and Prendergast
, P. J.
, 2004
, “Elastic Behavior of Porcine Coronary Artery Tissue Under Uniaxial and Equibiaxial Tension
,” Ann. Biomed. Eng.
, 32
(10
), pp. 1355
–1364
.10.1114/B:ABME.0000042224.23927.ce15.
Scheltes
, J. S.
, van Andel
, C. J.
, Pistecky
, P. V.
, and Borst
, C.
, 2003
, “Coronary Anastomotic Devices: Blood-Exposed Non-Intimal Surface and Coronary Wall Stress
,” J. Thorac. Cardiovasc. Surg.
, 126
(1
), pp. 191
–199
.10.1016/S0022-5223(03)00021-716.
Suyker
, W. J.
, Buijsrogge
, M. P.
, Suyker
, P. T.
, Verlaan
, C. W.
, Borst
, C.
, and Grundeman
, P. F.
, 2004
, “Stapled Coronary Anastomosis With Minimal Intraluminal Artifact: The S2 Anastomotic System in the Off-Pump Porcine Model
,” J. Thorac. Cardiovasc. Surg.
, 127
(2
), pp. 498
–503
.10.1016/j.jtcvs.2003.04.00617.
Ueda
, K.
, Mukai
, T.
, Ichinose
, S.
, Koyama
, Y.
, and Takakuda
, K.
, 2010
, “Bioabsorbable Device for Small-Caliber Vessel Anastomosis
,” Microsurgery
, 30
(6
), pp. 494
–501
.10.1002/micr.2076418.
Spector
, J. A.
, Draper
, L. B.
, Levine
, J. P.
, and Ahn
, C. Y.
, 2006
, “Routine Use of Microvascular Coupling Device for Arterial Anastomosis in Breast Reconstruction
,” Ann. Plast. Surg.
, 56
(4
), pp. 365
–368
.10.1097/01.sap.0000202614.45743.3419.
Gehrke
, C.
, Li
, H.
, Sant
, H.
, Gale
, B.
, and Agarwal
, J.
, 2014
, “Design, Fabrication and Testing of a Novel Vascular Coupling Device
,” Biomed. Microdevices
, 16
(1
), pp. 173
–180
.10.1007/s10544-013-9819-z20.
Chernichenko
, N.
, Ross
, D. A.
, Shin
, J.
, Chow
, J. Y.
, Sasaki
, C. T.
, and Ariyan
, S.
, 2008
, “Arterial Coupling for Microvascular Free Tissue Transfer
,” Otolaryngol. Head Neck Surg.
, 138
(5
), pp. 614
–618
.10.1016/j.otohns.2007.12.02921.
Lally
, C.
, Dolan
, F.
, and Prendergast
, P. J.
, 2005
, “Cardiovascular Stent Design and Vessel Stresses: A Finite Element Analysis
,” J. Biomech.
, 38
(8
), pp. 1574
–1581
.10.1016/j.jbiomech.2004.07.02222.
Yamada
, H.
, and Evans
, F. G.
, 1970
, Strength of Biological Materials
, Williams & Wilkins
, Baltimore, MD
.23.
Simon
, B. R.
, Kaufmann
, M. V.
, McAfee
, M. A.
, and Baldwin
, A. L.
, 1993
, “Finite Element Models for Arterial Wall Mechanics
,” ASME J. Biomech. Eng.
, 115
(4B), pp. 489
–496
.10.1115/1.289552924.
Khamdaeng
, T.
, Luo
, J.
, Vappo
, J.
, Terdtoon
, P.
, and Konofagou
, E. E.
, 2012
, “Arterial Stiffness Identification of the Human Carotid Artery Using the Stress–Strain Relationship In Vivo
,” Ultrasonics
, 52
(3
), pp. 402
–411
.10.1016/j.ultras.2011.09.00625.
Sommer
, G.
, Regitnig
, P.
, Költringer
, L.
, and Holzapfel
, G. A.
, 2010
, “Biaxial Mechanical Properties of Intact and Layer-Dissected Human Carotid Arteries at Physical and Supraphysical Loadings
,” Am. J. Physiol., Heart Circ.
, 298
(3), pp. 898
–912
.10.1152/ajpheart.00378.2009Copyright © 2015 by ASME
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