ABSTRACT
This study quantified arterial anastomotic tension, evaluated subsequent patency rates,
and examined the degree of tension reduction with vessel mobilization. The study was
divided into two components. In part 1, a mechanical analysis was undertaken to evaluate
tension, based on the determination of the force required to deflect a cable (vessel)
laterally, and its resulting lateral displacement. Six Sprague-Dawley rats with 12
femoral arteries were divided into two subgroups: 1) no mobilization; and 2) axial
mobilization by ligation and transection of superficial epigastric and gracilis muscular
branches. The tension of femoral arterial anastomoses was calculated in vessels with
no segmental defect and with 1.5-, 3-, 4.5-, 6-, and 7.5-mm defects. In part II, patency
was evaluated. Fifty-five rats with 110 femoral arteries were divided into two sub-groups
as defined in part 1:1) no mobilization; and 2) axial mobilization by ligation and
transection of superficial epigastric and gracilis muscular branches. Microvascular
anastomoses were performed with no segmental defect and with 1-, 2-, 3-, 4-, 5-, 6-,
7-, 8-, 9-, and 10-mm segmental vessel defects. Patency was evaluated 24 hr postoperatively.
Part I of the study revealed that anastomotic tension gradually increased along with
an increase in the length of the vessel defect, from 1.9 to 11.34 g in the no-mobilization
group and from 1.97 to 8.44 g in the axial-mobilization group. Comparison of tension
linear regression coefficient showed a significant difference between the two groups
(p < 0.05). In part II of the study, the maximum length of femoral artery defects still
able to maintain 100 percent patency of anastomoses was 4 mm (tension approximately
6 g) in the no-mobilization group and 6 mm in the axial-mobilization group (tension
approximately 6.48 g). Micro-anastomotic tension was related to the size of the vessel
defect, with increasing tension leading to thrombosis. Axial mobilization significantly
reduced the tension in vessels with segmental defects and decreased thrombosis rates.
