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Sutureless anastomoses: Secrets for success by Tozzy F.

By Tozzy F.

The suture procedure for vascular anastomosis building is changing into insufficient to fulfill new surgeon’s calls for and surgeons want an alternate strategy to build a skip as a way to lessen the technical call for and standardise the standard of the surgical procedure.This publication is devoted to surgeons, scholars, biomedical engineers and researchers with a distinct curiosity in vascular anastomosis and pass suggestions that are looking to replace their wisdom in regards to the significant determinants of anastomosis consequence and all of the latest possible choices to the suture strategy. the writer discloses the secrets and techniques and pitfalls of latest sutureless anastomotic units.

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Am J Physiol Heart Circ Physiol 280(5):H2300–H2305 27. Arndt JO, Kober G (1970) Pressure diameter relationship of the intact femoral artery in conscious man. Pflugers Arch 318:130–146 28. Weizsacker HW, Pinto JG (1988) Isotropy and anisotropy of the arterial wall. J Biomech 21(6):477–487 29. Lichtenstein O, Safar ME, Poitevin P, Levy BI (1995) Biaxial mechanical properties of carotid arteries from normotensive and hypertensive rats. Hypertension 26(1):15–19 30. Tozzi P, Hayoz D, Corno AF, Mallabiabarrena I, von Segesser LK (2003) Cross-sectional compliance overestimates arterial compliance because it neglects the axial strain.

Extremely skewed profiles towards the outer (far) wall occur in the anastomotic region and downstream forming a jet flow. Zones of recirculation are found on the artery floor opposite the junction. Axial and circumferential wall shear stress are demonstrated in Figure 5 at two chosen points on the hood and on the floor of cross-section B indicated in Figure 4 during the cardiac cycle. The comparison between the distensible wall models (bold line) and their referential rigid wall configurations corresponding to the diastolic geometry (thin line) do not show qualitative differences.

This relationship shows the importance of anatomically correct geometric modelling even if we still don’t handle phenomena like the non-planarity of curvature and branching in the arterial systems [16]. In the last ten years, the mechanical properties of the graft and the artery-graft connection have become a field of investigation with respect to the development of intimal hyperplasia, particularly at the suture line. From clinical and in vivo observations, it is known that the mismatch in artery-graft compliance can lead to graft failure [17, 18].

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