Intravascular stenting (IVaS) for safe and precise supermicrosurgery.

The diameter of very small vessels (about 0.5 mm or less) causes difficulties in placing forceps into the lumen and in completing anastomosis without inadvertently catching the back wall during supermicrosurgery. The insertion of nylon monofilaments into small vessels has overcome this problem. We implanted superficial inferior epigastric arterial (SIEA) flaps in 10 rats and also performed supermicroanastomosis (diameter, 0.15 mm) using SIEA flaps in mice. The back wall was never inadvertently caught using the intravascular stenting (IVaS) method, and the immediate patency rate was 100%. An advantage of using nylon for IVaS is that various sizes can be selected. We successfully anastomosed vessels with a minimum diameter of 0.15 mm. Even smaller vessels can be precisely and safely anastomosed using the IVaS method.