Experimental study on microsurgical vascular anastomosis guided by 3D-printed intravascular stent

doi:10.19438/j.cjoms.2026.03.003

Abstract

Abstract: PURPOSE: To explore the feasibility of 3D-printed internal stents in assisting microsurgical vascular anastomosis. METHODS: Twenty healthy New Zealand white rabbits were selected and subjected to a self-controlled design. The bilateral common carotid arteries were exposed and transected: the right side underwent traditional interrupted suture (control group), while the left side was anastomosed after implantation of a 3D-printed pure titanium internal stent (experimental group). The anastomosis time, immediate postoperative and 14-day postoperative vascular patency rates were recorded, and the incidence of anastomotic bleeding was statistically analyzed. RESULTS: The anastomosis time of the experimental group was (21.97±2.99) min, which was significantly shorter than that of the control group [(27.68±4.27) min, P<0.05]. The immediate postoperative patency rate was 100%(20/20) in the experimental group and 90%(18/20) in the control group; the 14-day postoperative patency rate was 95%(19/20) in the experimental group and 75%(15/20) in the control group, with no statistically significant difference in patency rate between the two groups (P>0.05). The bleeding rate of the experimental group was 5% (1/20), which was significantly lower than that of the control group (35%, 7/20, P<0.05). CONCLUSIONS: 3D-printed pure titanium internal stents can significantly shorten the microsurgical vascular anastomosis time and reduce the bleeding rate through mechanical support and suture guidance, without affecting vascular patency. At the same time, it reduces the reliance on the surgeon's fine suture skills, providing a new auxiliary solution for microsurgical vascular anastomosis.

Key words: Microsurgical vascular anastomosis, Intravascular stent, 3D printing, Microsurgery

CLC Number:

R782.05

Li Wenhao, Zhao Xue, Han Shaowei, Li Yahui, Huang Xu, Chen Chuanjun. Experimental study on microsurgical vascular anastomosis guided by 3D-printed intravascular stent[J]. China Journal of Oral and Maxillofacial Surgery, 2026, 24(3): 218-222.

References

[1] 侯春林. 中国显微外科发展历程[J]. 中华创伤骨科杂志, 2005, 7(1): 16-18.
Hou CL.Development of microsurgery in China[J]. Chinese Journal of Orthopaedic Trauma, 2005, 7(1): 16-18.
[2] Mengen LM, Horch RE, Arkudas A.Microsurgical vascular suture[J]. Oper Orthop Traumatol, 2024, 36(6): 307-319.
[3] Sadigh Y, Mechri I, Jain A, et al.Validation of novel microsurgical vessel anastomosis techniques: a systematic review[J]. J Reconstr Microsurg, 2025, 41(1): 28-36.
[4] Adam D, Broderick D, Kyzas P, et al.Microvascular anastomotic coupler devices versus hand-sewn technique for arterial anastomosis: a systematic review[J]. Br J Oral Maxillofac Surg, 2021, 59(5): 524-533.
[5] Pabittei DR, de Boon W, Heger M, et al. Laser-assisted vessel welding: state of the art and future outlook[J]. J Clin Transl Res, 2015, 1(2):1-18.
[6] Heitzer M, Brockhaus J, Kniha K, et al.Mechanical strength and hydrostatic testing of VIVO adhesive in sutureless microsurgical anastomoses: an ex vivo study[J]. Sci Rep, 2021, 11(1): 13598.
[7] 郭宏波, 宦玮, 尹任其, 等. 血管吻合技术的研究进展和应用现状[J]. 血管与腔内血管外科杂志, 2021, 7(7): 845-850.
Guo HB, Huan W, Yin RQ, et al.Advances and application of vascular anastomosis technology[J]. Journal of Vascular and Endovascular Surgery, 2021, 7(7): 845-850.
[8] Pour Farid P, Arkudas A, Horch RE.Mechanical vascular anastomoses[J]. Oper Orthop Traumatol, 2024, 36(6): 320-331.
[9] Wei FC, Mancer K, Zuker RM.The temporary stent technique: an easier method of micro-venous anastomosis[J]. Br J Plast Surg, 1982, 35(1): 92-95.
[10] Narushima M, Koshima I, Mihara M, et al.Intravascular stenting (IVaS) for safe and precise supermicrosurgery[J]. Ann Plast Surg, 2008, 60(1): 41-44.
[11] Saegusa N, Sarukawa S, Ohta K, et al.Sutureless microvascular anastomosis assisted by an expandable shape-memory alloy stent[J]. PLoS One, 2017, 12(7): e0181520.
[12] 胡业帅, 钱海, 刘方军, 等.采用大鼠颈动脉进行显微血管吻合技术训练的可行性研究[J]. 临床神经外科杂志, 2020, 17(2): 188-191.
Hu YS, Qian H, Liu FJ, et al.Value of end-to-end rat carotid artery anastomosis in microtechnique training for beginners[J]. Journal of Clinical Neurosurgery, 2020, 17(2): 188-191.
[13] Hayhurst JW, O'Brien BM. An experimental study of microvascular technique, patency rates and related factors[J]. Br J Plast Surg, 1975, 28(2): 128-132.
[14] Narushima M, Mihara M, Yamamoto Y, et al.The intravascular stenting method for treatment of extremity lymphedema with multiconfiguration lymphaticovenous anastomoses[J]. Plast Reconstr Surg, 2010, 125(3): 935-943.
[15] Sert G, Aksoyler D, Kara M, et al.Comparison of total anastomosis time between four different combinations of suturing and knot tying techniques in microsurgical anastomosis[J]. J Plast Surg Hand Surg, 2023, 57(1-6): 240-246.
[16] Xiao Z, Samii M, Wang J, et al.Training model for the intraluminal continuous suturing technique for microvascular anastomosis[J]. Sci Rep, 2021, 11(1): 4862.
[17] Tahmasebi E, Hajisadeghi S, Shafiei S, et al.Factors affecting anastomosis failure in microvascular fibula flap reconstruction of the maxillofacial region: a systematic review and meta-analysis[J]. J Korean Assoc Oral Maxillofac Surg, 2025, 51(1): 3-16.
[18] Li X, Liu C, Hu H.Prevailing insights into anastomotic angles of surgically created arteriovenous fistulas: a literature review[J]. BMC Nephrol, 2025, 26(1): 252-261.
[19] 陈传俊, 吴晓亮, 朱祖武, 等.延迟打结全程单线双针显微血管吻合法的临床价值及其可行性[J].安徽医学, 2008, 29(2): 103-105.
Chen CJ, Wu XL, Zhu ZW, et al.The clinical significance of delayed knotting with single-thread double needle anastomosis over the entire microvascular anastomotic period and its feasibility[J]. Anhui Medical Journal, 2008, 29(2): 103-105.
[20] Bao B, Gao T, Li X, et al.Breaking the technical barrier of microvascular anastomosis with high-speed videography: a prospective cohort study[J]. Int J Surg, 2022, 98: 106214.