Comparison of cyanoacrylate-assisted arteriotomy closure with conventional closure technique

BACKGROUND
We aimed to compare conventional suture closure of arteriotomy with N-butyl-cyanoacrylate-assisted suture closure.
METHODS
Forty Wistar rats were randomly divided into two groups. Standard arteriotomy was performed to the abdominal aorta through a midline incision. In the first group, arteriotomy was closed by 3 stitches with 45° between each and in the second by two stitches with 0.1 ml (12-12.5 mg) cyanoacrylate. Amount of blood loss, operation time and severity of myointimal hyperplasia by immunohistochemistry on aorta segments were measured on postoperative days 7 and 30.
RESULTS
Mean anastomotic time was 13.5±1.64 in the first and 13.0±1.75 min in the second group (p=0.356). Operation time was 23.45±3.63 in the control and 21.0±3.09 min in the second group (p=0.027). Mean amount of bleeding was 473.75± 260.5 in the first and 327.5± 155.36 μl in the second group (p=0.037). Intimal thickness on the 7th day was 80.62±7.92 in the first and 83.24±3.42 μm in the second group, and on the 30th day was 81.64±5.11 in the first and 88.77±11.03 μm in the second group. The early and late intimal thicknesses were similar (p=0.35 and 0.87, respectively).
CONCLUSION
Reconstruction of arteriotomies with fewer sutures in combination with cyanoacrylate is a safe method associated with less blood loss and shorter operation time. It also does not lead to increased myointimal hyperplasia.

Siyanoakrilat yardýmlý arteriyotomi kapama tekniðinin konvansiyonel kapama tekniði ile karþýlaþtýrýlmasý

AMAÇ
Arteriyotomi sonrasý, konvansiyonel dikiþ tekniði ile n-bütil-2-siyanoakrilat yardýmlý kapama tekniði karþýlaþtýrýldý.
GEREÇ VE YÖNTEM
Kýrk adet Wistar sýçan randomize olarak 2 gruba ayrýldý. Orta hat kesisiyle abdominal aortaya standart arteriyotomi uygulandý. Arteriyotomi, birinci grupta aralarýnda 45° açýyla 3 adet; ikinci grupta ise 60° açýyla 2 adet dikiþle kapatýldý. Ýkinci gruba 0,1 ml (12-12,5 mg) siyanoakrilat uygulandý. Operasyon zamaný, kanama miktarý ve aortanýn çýkarýlan anastomotik segmentinde cerrahi sonrasý 7. ve 30. günlerde immünohistokimyasal olarak miyointimal hiperplazinin þiddeti deðerlendirildi.
BULGULAR
Ortalama anastomoz zamaný 1. grupta 13,5±1,64 dk, 2. grupta 13,0±1,75 dk idi (p=0,356). Ameliyat süresi kontrol grubunda 23,45±3,63 dk, tedavi grubunda 21,0±3,09 dk olarak saptandý (p=0,027). Ortalama kanama miktarý 1. grupta 473,75±260,5 μl, 2. grupta 327,5±155,36 μl idi (p=0,037). Yedinci günde yapýlan ölçümde intima kalýnlýðý 1. grupta 80,62±7,92 μm, 2. grupta 83,24±3,42 μm; 30. günde 1. grupta 81,64±5,11 μm, 2. grupta 88,77±11,03 μm olarak bulundu. Erken ve geç ölçümlerde intima kalýnlýklarý benzer düzeylerdeydi (sýrasýyla p=0,35 ve p=0,87).
SONUÇ
Arteriyotomilerin daha az dikiþle, n-bütil-2-siyanoakrilat birleþimiyle rekonstrüksiyonu, daha az kanama ve daha kýsa ameliyat süreleri ile seyreden güvenilir bir yöntemdir. Ayrýca, miyointimal hiperplazide artýþa neden olmamýþtýr.