Optimum anastomosis angle of end-to-side microsurgical anastomosis for preventing future shear-related risk of thrombosis by computationalmodeling

Abstract

End-to-side (ETS) microsurgical anastomosis is a powerful technique in microsurgery. It can overcome vessel's diameter discrepancy and preserve the distal blood flow. Optimal angle of the ETS anastomosis has been debated and studied, and is currently limited to animal models. Computational model using Finite Element Analysis (FEA) was used to simulate the models with 45 (model45), 90 (model90), and 135 (model135) ETS anastomosis angles. Flow dynamics including flow velocity and wall shear rate were studied and compared. Maximum flow velocity ranged from the highest to the lowest in model135, model90, and model45, respectively. The velocity in model135 showed fluctuation flow. The maximum wall shear rate and distribution were highest in model45 and lowest in model90. ETS anastomosis angle of 90 degrees provided the most favourable flow dynamics to prevent shear related thrombosis in comparison to ETS anastomosis at 45 and 135 degrees.