J Korean Orthop Assoc.  2008 Feb;43(1):36-42. 10.4055/jkoa.2008.43.1.36.

Easy and Fast Anastomosis using Microvascular Anastomotic Coupler System

• Chung NY
• Lim HC
• Lee SH
• Park JH
• Park JW

• KMID: 2106414
• DOI: http://doi.org/10.4055/jkoa.2008.43.1.36

Abstract

PURPOSE: We report the results of microvascular anastomosis using a microvascular anastomotic coupler (MAC) system.
MATERIALS AND METHODS
Twenty cases (12 patients) of venous anastomoses performed using a coupler system were examined. The patients' age, gender, preoperative diagnosis, donor tissue, vessel diameters, size of coupler, time for anastomosis, patency rate immediately after surgery and the final survival rate of the transferred tissue were evaluated.
RESULTS
The mean time for anastomosis using the coupler system was 3 min and 15 sec. The immediate patency rate after anastomosis was 100% without any leakage of blood or thrombus formation. At the final follow up, the transferred tissue survived in all cases.
CONCLUSION
Microvascular anastomosis using a coupler system in orthopaedic reconstructive surgery can shorten the vascular anastomosis time and significantly reduce the total ischemic time of the transferred tissue. This system can be easily used after a short training period. This system minimizes the intimal damage of the vessel, easily overcomes the diameter discrepancy and provides secure fixation at the anastomosis site. This system can be a good strategy for substituting the conventional suture anastomosis.

Keyword

MAC coupler; Vascular anastomosis

MeSH Terms

Follow-Up Studies
Glycosaminoglycans
Humans
Survival Rate
Sutures
Thrombosis
Tissue Donors
Glycosaminoglycans

Figure

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  Fig. 1 MAC coupler®, Synovis Life Technology, Birmingham, AL.

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  Fig. 2 (A) Chronic tibial osteomyelitis with pretibial skin defect. (B) Seventeen cm sized free vascularized fibula osteocutaneous flap was harvested. (C) Vascular anastomosis with MAC coupler system. (D) Postoperative 1 yr photograph and radiographs showed survived skin flap and union of a grafted fibula on the x-ray.

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  Fig. 3 (A) Grafted nonvascularized fibula was fractured with metal failure after the osteosarcoma resection. (B) Eighteen cm sized free vascularized fibula was harvested. (C) Vascular anastomosis with MAC coupler system. (D) Postoperative 15 month radiograph shows union of a grafted free vascularized fibula.

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