An intraluminal stent facilitates light-activated vascular anastomosis.

Background: Photochemical tissue bonding (PTB) is a sutureless, light-activated technique that produces a watertight, microvascular repair with minimal inflammation compared to standard microsurgery. However, it is practically limited by the need for a clinically viable luminal support system. The aim of this study was to evaluate a hollow biocompatible stent to provide adequate luminal support to facilitate vascular anastomosis using the PTB technique. Methods: Forty rats underwent unilateral femoral artery transection. Five rats were used to optimize the stent delivery method and the remaining 35 rats were randomized into three groups: 1) standard suture repair with 10-0 nylon microsuture (SR), 2) standard suture repair over the stent (SR+S), or 3) PTB repair over stent (PTB+S). For the PTB group, a 2 mm overlapping cuff was painted with 0.1% (w/v) Rose Bengal then illuminated for 30 seconds on each side (532 nm, 0.5 W/cm2, 30 J/cm2). Anastomotic leak and vessel patency (immediate, 1 hour and 1 week, post-operatively) were assessed. Results: Vessels in all three groups were patent immediately and at 1 hour post-operatively. After 1 week all animals displayed patency in the SR group while only 5/14 and 2/8 surviving animals had patent vessels in the PTB+S and SR+S groups, respectively. Conclusions: This study demonstrated successful use of an intraluminal stent for acute microvascular anastomosis using the PTB technique. However, the longer-term presence of the stent at the anastomotic site led to thrombosis in multiple cases. A rapidly dissolvable stent should facilitate a light-activated microvascular anastomosis with excellent long-term patency. (C) 2017 Lippincott Williams & Wilkins, Inc.

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