Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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A comparison study of vessel twisting by different microsurgical suture techniques in a chicken wing artery side to side bypass training model

  • Junho Jung (Department of Neurosurgery, Hallym University Dongtan Sacred Heart Hospital) ;
  • Donghwan Jeong (Department of Neurosurgery, Danwon Hospital)
  • Received : 2023.01.19
  • Accepted : 2023.04.18
  • Published : 2023.09.30
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Abstract

Objective: Microvascular anastomosis, particularly side-to-side (STS) bypass, is a complex surgical procedure. While several suture techniques exist, none of them is superior to the others. We assessed the association between various STS bypass techniques and vessel twisting using chicken wing training models. Methods: Three suture techniques were compared over an anterior wall suture procedure. The unidirectional continuous suture (UCS) group used a downward "right-to-left" continuous suture. The reverse continuous suture (RCS) group used a downward "left-to-right" continuous suture. The interrupted suture (IS) group used the standard interrupted suture. The number of samples in each of the three groups was 30 (n=90). We compared the incidence of vessel twisting and rotation angles across groups. Results: Vessel twisting occurred in 96.7%, 56.7%, and 0% of the cases in the UCS, IS, and RCS groups, respectively. The incidence of vessel twisting differed significantly in all 3 groups (p<0.001), with an apparent trend (p=0.002). The mean rotation angles were 201°±90.6°, 102°±107.6°, and 0° in the UCS, IS, and RCS groups, respectively, which were significantly different (p<0.001). On excluding cases without twisting, the rotation angles of twisted vessels in the UCS and IS groups were 207.9°±83.7° and 180°±77.9°, respectively, which yielded a significant difference between these groups (p<0.001). Conclusions: We found that the incidence and trend of vessel twisting differed significantly across suture techniques. The RCS technique may aid in preventing vessel twisting in the STS bypass procedure.

Keywords

Acknowledgement

This study was approved by a local institutional review board (NON2021-002). We thank Youngmi Kim for drawing works.

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