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Medicine Science

Joining Blood Vessels Without Sutures 54

Posted by Soulskill
from the what-can't-duct-tape-do dept.
Med-trump writes "Stanford microsurgeons have used a poloxamer gel and bioadhesive, rather than a needle and thread, to join together blood vessels. The technique, published in the recent issue of Nature Medicine, may replace the 100-year-old method of reconnecting severed blood vessels with sutures. According to the authors of the study, 'ultimately, this has the potential to improve patient care by decreasing amputations, strokes and heart attacks while reducing health-care costs.'"
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Joining Blood Vessels Without Sutures

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  • Another human invention that's been around since the dawn of time!
  • "ultimately, this has the potential to improve patient care by decreasing amputations, strokes and heart attacks while reducing health-care costs"... For the insurance companies. What are the odds those savings will be passed on to the patients?
    • by pnewhook (788591)

      For the insurance companies. What are the odds those savings will be passed on to the patients?

      All you have to do is to cut the bloodsucking insurance companies out and go total socialized health care like Canada, and everyone will win.

      • Re:Reducing Costs... (Score:5, Informative)

        by sgt scrub (869860) <saintium@@@yahoo...com> on Monday August 29, 2011 @11:46AM (#37243090)

        Canada is a AAA rated country. They can afford to give a shit.

        • Yep. And we did it by letting ourselves be taxed. (And bumming off the Yanks, when circumstances necessitated it. But it's mostly about not hating strangers.)
      • by umghhh (965931)
        probably not quite true. Neither way has only bad or good sides. The fact that US f.d up is telling. Germany is going the same way too. I think Holland tried to change their system in such where basic coverage is for everyone and everyone living there has to have basic insurance which from what I know is bought from private companies which in turn are obliged by law to accept everybody. On top of this system is private insurance for those who can and want to have an insurance providing a bit more sophistica
        • by pnewhook (788591)

          I have had several eye opening experience with Canadian health care. First was my dad who got a pacemaker - he was in surgery the next morning after being diagnosed and that probably saved his life. Top of the line pacemaker that apparently cost $30 for just the part in the US.

          My personal experience was with our first child that was born premature. Amazing care by a team of doctors and specialists for two months in the NICU, and followup monitoring care until he is three. The only thing I had to pay for

  • This isn't exactly super-new - it's expanding the scope of an existing technique to cases where it hasn't been used before.

    Using glue instead of sutures has been around for at least a decade - after getting hit in the face with a hockey pick around 1999-2000, instead of stitches the local hospital glued together the gash above my eye where the lens from my glasses pushed in. (Thank God for shatterproof polycarbonate lenses - the lens saved my eye.) The glue worked very well - not even the slightest scar r

    • by Iron Chef Unix (582472) on Monday August 29, 2011 @11:48AM (#37243118)
      It's not the glue that is novel in this application, but the use of a poloxamer gel to keep the vessel shape while attaching the ends.

      Imagine trying to glue together the open ends of two tube socks. It would be time consuming to line up the ends and not glue the other side together, etc. This technique is like putting a solid round canister inside the junction of the two tubes, making it very quick to line up the edges and glue them together.

      In this case the canister is a cylinder of poloxamer gel that is solid when warmed above body temperature. After the connection is glued, the gel cools and liquifies, leaving a perfectly glued joint.
      • by yog (19073) *

        Furthermore, we're talking about tubes less than 1mm in diameter. Actually, it's quite an achievement to recreate these connections and have them heal that well. It sounds simple, but it's not.

        • by Pope (17780)

          Furthermore, we're talking about tubes less than 1mm in diameter.

          Huh. So that's what the internet was like in the 70s.

        • by X0563511 (793323)

          I imagine the ability to repair such small vessels will help a patient keep sensation in the area of an operation?

  • by JoshuaZ (1134087) on Monday August 29, 2011 @11:43AM (#37243048) Homepage
    According to TFA a major part of this is the use of a polymer that solidifies when heated but dissolves when it cools down. It is striking that we can not only have such weird substances but can have such substances that are also reasonably ok inside humans (that is, not poisonous and not triggering an immune response). The main advantages of this method is that it is faster than the normal method and that it can be applied to much smaller blood vessels. According to TFA, suturing is extremely difficult if not outright impossible for blood vessels that are smaller than 1 milimeter wide. The basic type of polymer has been used in various forms before to deliver drugs, so while this version is a modified version, it is unlikely that any very serious problems will crop up. Overall, this will be helpful in for both planned and emergency surgeries and should help reattach limbs and digits much more effectively. Right now when a finger is removed reattachment is a difficult process that often just fails. This should change that.
    • by ColdWetDog (752185) on Monday August 29, 2011 @12:42PM (#37243870) Homepage

      Actually, it's more than that. Microvascular work requires a lot of training and specialized equipment. IF (big IF) this pans out, then it's possible that some dumb ol ER doc (ie, me) can put together blood vessels where today we either have to ship them someplace that has the personnel and equipment (slow and expensive) or just wack off the broken bits (cheap, fast but sometimes you want the little pieces part that's left on the floor).

      Cool idea. We'll see if it pans out in clinical trials (most cool ideas don't unfortunately).

    • by timeOday (582209)
      How in the heck did they make it freeze when it gets hot and melt when it cools off?
      • Poloxamers are, as the Nature Medicine abstract describes, a triblock polymer. Blocks in polymerization are created by polymerizing one monomer chemical to create a chain, and then introducing another monomer to polymerize at the still reactive end of the original chain. This can be used to create a polymer that has regions of different properties. In the case of poloxamers, the blocks on the ends are polyethylene glycol while the middle block is less-soluble polypropylene glycol. This gives the chain a
  • For those who didn't read the link, the problem is, "How do you glue the ends of a tiny blood vessel together without gluing the lumen of the vessel shut?" Answer is that you need a temporary plug that sits inside and joins the two ends together, while propping it open until the glue sets.

    The clever part was finding a material (the polaxamer) that is solid enough to do the job, but melts away at the right speed afterwards, without toxicity.

    • by Anonymous Coward

      "How do you glue the ends of a tiny blood vessel together without gluing the lumen of the vessel shut?" Answer is that you need a temporary plug that sits inside and joins the two ends together, while propping it open until the glue sets.

      Also, a lot of people don't know that surgeons have been gluing (larger) blood vessels together, instead of suturing with needle and thread for decades already. Cyanoacrylates (superglues) were used outside the USA in medical applications since the 1970's, and speci

    • by tibit (1762298)

      Is it possible to use a needle inserted into the vessel, that you then simply take out by poking a hole in the vessel? Perhaps the vessel can stretch so that a you won't have a big gash in it? How stretchable are small blood vessels"

  • How long until they can suture a wound above the spinal cord with can'd foam.

    • not until River Tam goes bonkers and start beating people up. Obligatory xkcd [xkcd.com] comic.
    • How long until they can suture a wound above the spinal cord with can'd foam.

      Neurons are harder to deal with than blood vessels. They're more complicated. There are more of them. They are lots smaller.

      So probably not for some time.

  • "Oh, I'd give a lot to see the hospital. Probably...needles and...sutures. All the pain. They used to hand-cut and sew people like garments. Needles and sutures...all the terrible pain!"

    -McCoy, City on the Edge of Forever

  • ITYM "reduce heath care costs once the patent expires". Time and again, a breakthrough at a tax-supported university that's supposed to improve healthcare for all mankind becomes a privately-held patent that is used to gouge those who can afford it. Considering Stanford is a private school which accepts very little money from public sources and only for specific projects, there's even less reason for the public to even expect this will be freely available technology.

  • I think it is so awesome to have some innovative way of doing things that is less intrusive to the body, and gives the same results....

Sigmund Freud is alleged to have said that in the last analysis the entire field of psychology may reduce to biological electrochemistry.

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