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Current suture-less devices accelerate anastomosis but are constrained by vessel-size mismatch, eversion-related intimal injury, and inconsistent arterial performance. A clinically adaptable, arterial-capable system is needed. We developed a customizable, 3D-printed intraluminal coupler with a snap-fit connection and elastic external clasp that avoids vessel eversion and preserves length. Devices were fabricated via SLA or PolyJet printing using clinically used resins. Benchtop evaluation included burst-pressure testing, tensile testing, wettability and endothelial cytocompatibility assays with oxygen-plasma surface modification. Deployment was assessed ex vivo using porcine coronary vessels and in vivo in a porcine carotid arterial model with patency monitoring over 4\u00a0h. Couplers sustained leakage pressures of ~\u200990 mmHg vs. ~16 mmHg for hand-sutured controls (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.01), while maintaining comparable mechanical strength (\u2248\u20092\u20133\u00a0N). Plasma surface treatment reduced water contact angles (\u2248\u200985\u00b0\u2192\u224860\u00b0) and tripled endothelial attachment, restoring confluent morphology. Ex vivo deployment achieved completion in 9.47\u2009\u00b1\u20091.20\u00a0min, a\u2009~\u200962.5% reduction vs. published suturing times. In vivo, couplers restored immediate perfusion with no leakage or thrombosis. This 3D-printed intraluminal coupler demonstrates mechanical feasibility, rapid deploy-ability, and surface-modifiable endothelial compatibility in benchtop and short-term large-animal feasibility testing, supporting its potential for further preclinical development as a vascular anastomosis technology. Future survival studies and anti-thrombogenic surface engineering will advance readiness for clinical implementation.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-39181-4","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T13:48:29Z","timestamp":1770990509000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["In vitro and in vivo validation of a novel 3D-printed vessel anastomosis device for microvascular surgery"],"prefix":"10.1038","volume":"16","author":[{"given":"John Ser Pheng","family":"Loh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Che","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijia","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinling","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Heymann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Rasmusson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin Kok Soon","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwa Liang","family":"Leo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhilde","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"issue":"4","key":"39181_CR1","doi-asserted-by":"publisher","first-page":"820","DOI":"10.3390\/clinpract13040074","volume":"13","author":"A Papanikolaou","year":"2023","unstructured":"Papanikolaou, A. et al. Free tissue transfer in head and neck reconstruction: A multidisciplinary 15-year experience. Clin. Pract. 13(4), 820\u2013829 (2023).","journal-title":"Clin. Pract."},{"key":"39181_CR2","doi-asserted-by":"crossref","unstructured":"Rickard, R. F. & Hudson, D. A. A history of vascular and microvascular surgery. Ann. Plast. Surg. 73(4), 465\u2009\u2013472 (2014).","DOI":"10.1097\/SAP.0b013e3182710027"},{"issue":"2","key":"39181_CR3","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1007\/s00405-016-4360-3","volume":"274","author":"O Dassonville","year":"2017","unstructured":"Dassonville, O. et al. Multicenter prospective micro-costing study evaluating mandibular free-flap reconstruction. Eur. Arch. Otorhinolaryngol. 274(2), 1103\u20131111 (2017).","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"39181_CR4","first-page":"73","volume":"38","author":"JG Ribaudo","year":"2024","unstructured":"Ribaudo, J. G. et al. 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