Sutureless vascular anastomotic approaches and their potential impacts

Joseph G. Ribaudo, Kevin He, Sarah Madira, Emma R. Young, Cameron Martin, Tingying Lu, Justin M. Sacks, Xiaowei Li

Research output: Contribution to journalReview articlepeer-review

Abstract

Sutureless anastomotic devices present several advantages over traditional suture anastomosis, including expanded global access to microvascular surgery, shorter operation and ischemic times, and reduced costs. However, their adaptation for arterial use remains a challenge. This review aims to provide a comprehensive overview of sutureless anastomotic approaches that are either FDA-approved or under investigation. These approaches include extraluminal couplers, intraluminal devices, and methods assisted by lasers or vacuums, with a particular emphasis on tissue adhesives. We analyze these devices for artery compatibility, material composition, potential for intimal damage, risks of thrombosis and restenosis, and complications arising from their deployment and maintenance. Additionally, we discuss the challenges faced in the development and clinical application of sutureless anastomotic techniques. Ideally, a sutureless anastomotic device or technique should eliminate the need for vessel eversion, mitigate thrombosis through either biodegradation or the release of antithrombotic drugs, and be easily deployable for broad use. The transformative potential of sutureless anastomotic approaches in microvascular surgery highlights the necessity for ongoing innovation to expand their applications and maximize their benefits.

Original languageEnglish
Pages (from-to)73-94
Number of pages22
JournalBioactive Materials
Volume38
DOIs
StatePublished - Aug 2024

Keywords

  • Anastomotic device
  • OUTLINE
  • Patency
  • Sutureless
  • Tissue adhesive
  • Vascular

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