Mechanical strength and hydrostatic testing of VIVO adhesive in sutureless microsurgical anastomoses: an ex vivo study

Conventional anastomoses with interrupted sutures are challenging and inevitably associated with trauma to the vessel walls. The goal of this study was to evaluate a novel alternative adhesive-based suture-free anastomosis technique that uses an intraluminal stent. Overall, 120 porcine coronary vessels were analyzed in an ex vivo model and were examined for their mechanical (n=20 per cohort) and hydrostatic strength (n=20 per cohort). Anastomoses were made using the novel VIVO adhesive with an additional intraluminal nitinol stent and was compared to interrupted suture anastomosis and to native vessels. Sutureless anastomoses withstood pressures 299 +/- 4.47 [mmHg] comparable to native vessels. They were performed significantly faster 553.8 +/- 82.44 [sec] (p <= 0.001) and withstood significantly higher pressures (p <= 0.001) than sutured anastomoses. We demonstrate that the adhesive-based anastomosis can also resist unphysiologically high longitudinal tensile forces with a mean of 1.33 [N]. Within the limitations of an in vitro study adhesive-based suture-free anastomosis technique has the biomechanical potential to offer a seamless alternative to sutured anastomosis because of its stability, and faster handling. In vivo animal studies are needed to validate outcomes and confirm safety.

Automated summary

The novel adhesive-based suture-free anastomosis technique, using an intraluminal stent, demonstrated comparable hydrostatic strength to sutured anastomoses in an ex vivo model. It was performed significantly faster and withstood higher pressures, showing biomechanical potential as a seamless alternative to conventional anastomoses. In vivo animal studies are needed for further validation and to confirm safety.