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Published in: Acta Neurochirurgica 1/2020

01-01-2020 | Laser | Original Article - Vascular Neurosurgery - Other

Feasibility of the new sutureless excimer laser-assisted non-occlusive anastomosis clip in a rabbit model

Authors: B. de Boer, T. P. C. van Doormaal, D. Stecher, S. Redegeld, C. A. F. Tulleken, L. Regli, A. van der Zwan

Published in: Acta Neurochirurgica | Issue 1/2020

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Abstract

Background

The excimer laser-assisted non-occlusive anastomosis (ELANA) technique facilitates the construction of anastomoses without temporary occlusion of the recipient artery. Experiments aimed at simplifying the technique eventually resulted in a sutureless ELANA slide (SEsl) anastomosis. After the first clinical use, new insights lead to the application of a clip at the back of the device, the SELANA clip (SEcl). The SEcl offers a distinct advantage over the SEsl since no sealant is necessary. In this study, we determine the feasibility of the SEcl anastomosis in an in vivo rabbit model.

Methods

15 SEcl anastomoses and 15 conventional ELANA anastomoses were created on the abdominal aorta in 5 rabbits. Mean application times, flap retrieval rates, hemostasis, and burst pressures were assessed.

Results

The mean application time of the SEcl anastomoses was 11.4 min versus 39.0 min for the ELANA anastomoses (mean difference, 27.6 min; 95% CI, 20.6–34.7). The flap retrieval rate of the SEcl anastomoses (14/15) was not inferior to the flap retrieval rate of the ELANA anastomoses (13/15). Direct hemostasis was achieved in 13/15 (87%) SEcl anastomoses and in 14/15 (94%) ELANA anastomoses. All SEcl anastomoses were resistant to provoked pressures until 250 mmHg.

Conclusion

The SEcl anastomosis is technically feasible in in vivo experiments. Mean application time, flap retrieval rate, hemostasis, and burst pressure are not inferior to the conventional ELANA anastomosis. Further long term experiments should be performed to assess safety, patency, and reendothelialization.
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Metadata
Title
Feasibility of the new sutureless excimer laser-assisted non-occlusive anastomosis clip in a rabbit model
Authors
B. de Boer
T. P. C. van Doormaal
D. Stecher
S. Redegeld
C. A. F. Tulleken
L. Regli
A. van der Zwan
Publication date
01-01-2020
Publisher
Springer Vienna
Keyword
Laser
Published in
Acta Neurochirurgica / Issue 1/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-019-04105-x

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