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Vascular reconstruction

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https://www.readbyqxmd.com/read/28097212/feasibility-of-reduced-dose-three-dimensional-four-dimensional-digital-subtraction-angiogram-using-a-weighted-edge-preserving-filter
#1
Erick L Oberstar, Michael A Speidel, Brian J Davis, Charles M Strother, Charles A Mistretta
A conventional three-dimensional/four-dimensional (3D/4D) digital subtraction angiogram (DSA) requires two rotational acquisitions (mask and fill) to compute the log-subtracted projections that are used to reconstruct a 3D/4D volume. Since all of the vascular information is contained in the fill acquisition, it is hypothesized that it is possible to reduce the x-ray dose of the mask acquisition substantially and still obtain subtracted projections adequate to reconstruct a 3D/4D volume with noise level comparable to a full-dose acquisition...
January 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28093632/ureterocystoneostomy-in-complex-oncological-cases-with-an-uebelhoer-modified-boari-bladder-flap
#2
Jan P Radtke, Nina Korzeniewski, Johannes Huber, Celine D Alt, Sascha Pahernik, Boris A Hadaschik, Markus Hohenfellner, Dogu Teber
PURPOSE: The study aims to describe the technique and analyze the outcome of an arcuated bladder incision with building of a triangular flap, first described by Uebelhoer (UBBF), as a modification of the classical rectangular Boari bladder flap (BBF), that is often viable, but can present difficulties, such as reduced flap vascularization and mobility in pretreated patients. METHODS: Twelve consecutive patients with distal or mid ureteral leakage or stenosis, that underwent UBBF, were retrospectively analyzed...
January 16, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#3
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28079700/the-chimera-flap-a-quarter-century-odyssey
#4
Geoffrey G Hallock
Incredibly complicated multidimensional defects have always strained the ingenuity of the reconstructive surgeon. Secondary perhaps to vascularized composite allotransplantation as a solution to this dilemma, the compound flap has been developed to be a more useful and available alternative. Their greatest versatility has been proven by its subtype, the chimera flap. The chimera flap itself consists of multiple flaps, the latter possibly composed of bone, skin, muscle, and so on, where each part has an independent vascular supply, and each part is independent of any physical interconnection whatsoever with the other components, except where joined ultimately only to a common vascular pedicle...
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28076936/histochemical-and-morphological-aspects-of-fresh-frozen-bone-a-preliminary-study
#5
F S De Ponte, G Cutroneo, R Falzea, G Rizzo, L Catalfamo, A Favaloro, G Vermiglio, M Runci, A Centofanti, G Anastasi
Bone graft are used in dentistry for the reconstruction of severely atrophic jaws. Fresh frozen bone has no osteogenic property but it has osteoconductive and osteoinductive properties because its matrix contains growth factors such as vascular endothelial growth factor. The purpose of the present study was to evaluate morphological and protein expression characteristics of fresh frozen bone before graft and after six months of graft in patients who needed maxillary reconstruction. After 6 month of graft we observed the presence of viable bone as evidenced by full osteocyte lacunae and by the presence of RANKR, osteocalcin positive cells and vascular endothelial growth factor...
December 6, 2016: European Journal of Histochemistry: EJH
https://www.readbyqxmd.com/read/28076887/in-vivo-bone-tunnel-evaluation-of-nanoparticle-grafts-using-an-acl-reconstruction-rabbit-model
#6
S A Grant, S E Smith, H Schmidt, F Pfeiffer, K Kuroki, S Sherman, R A White, D A Grant
Acellular human gracilis tendons conjugated with gold nanoparticles (AuNP) and hydroxyapatite nanoparticles (nano-HAp) were used as a graft in an anterior cruciate ligament (ACL) reconstruction rabbit model. The ACLs of 11 New Zealand rabbits were reconstructed using grafts conjugated without nanoparticles, with AuNP only, and with both AuNP and nano-HAp. Semi-quantitative histological scoring of bone tunnel portion of grafts was performed after 14 weeks. Bone tunnels were scored for graft degeneration, graft remodeling, percentage of new host fibrous connective, collateral connection, head-to-head connection, graft collagen fiber organization, new host fibrous connective tissue organization, and graft and interface vascularity...
January 11, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28072496/structural-reconstruction-of-the-perivascular-space-in-the-adult-mouse-neurohypophysis-during-an-osmotic-stimulation
#7
K Nishikawa, E Furube, S Morita, N Horii-Hayashi, M Nishi, S Miyata
Oxytocin (OXT) and arginine vasopressin (AVP), neuropeptides in the neurohypophysis (NH), control lactation and body fluid homeostasis, respectively. Hypothalamic neurosecretory neurons project their axons from the supraoptic and paraventricular nuclei to the NH to make contact with the vascular surface and release OXT and AVP. The neurohypophysial vascular structure is unique, because it has a wide perivascular space between the inner and outer basement membranes. However, the significance of this unique vascular structure remains unclear; therefore, we aimed to elucidate the functional significance of the perivascular space and its activity-dependent changes during salt loading in adult mice...
January 10, 2017: Journal of Neuroendocrinology
https://www.readbyqxmd.com/read/28070843/noise-optimized-monoenergetic-post-processing-improves-visualization-of-incidental-pulmonary-embolism-in-cancer-patients-undergoing-single-pass-dual-energy-computed-tomography
#8
Jakob Weiss, Mike Notohamiprodjo, Malte Bongers, Christoph Schabel, Stefanie Mangold, Konstantin Nikolaou, Fabian Bamberg, Ahmed E Othman
PURPOSE: To evaluate noise-optimized monoenergetic postprocessing of dual-energy CT (DE-CT) on image quality in patients with incidental pulmonary embolism in single-pass portal-venous phase CT (CTpv). MATERIALS AND METHODS: 20 Consecutive patients with incidental pulmonary embolism in contrast-enhanced oncological follow-up DE-CTpv examination were included in this study. Images were acquired with a 3rd generation DE-CT system in DE mode (100/Sn150 kV) and activated tube current modulation 90 s after contrast agent administration...
January 9, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28070690/reconstruction-of-defects-of-the-trachea
#9
Margot Den Hondt, Jan Jeroen Vranckx
The trachea has a complex anatomy to fulfill its tasks. Its unique fibro-cartilaginous structure maintains an open conduit during respiration, and provides vertical elasticity for deglutition, mobility of the neck and speech. Blood vessels pierce the intercartilaginous ligaments to perfuse the ciliated epithelium, which ensures effective mucociliary clearance. Removal of a tracheal segment affected by benign or malignant disease requires airtight restoration of the continuity of the tube. When direct approximation of both tracheal ends is no longer feasible, a reconstruction is needed...
February 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28069880/repair-of-a-bowel-containing-scrotal-hernia-with-incarceration-contributed-by-femorofemoral-bypass-graft
#10
Gaurav Sharma, Jonathan A Schouten, Kamal M F Itani
The rising use of endovascular techniques utilizing femoral artery access may increase the frequency with which surgeons face the challenge of hernia repair in reoperative groins-which may or may not include a vascular graft. We present a case where a vascular graft contributed to an acute presentation and complicated dissection, and review the literature. A 67-year-old man who had undergone prior endovascular aneurysm repair via open bilateral femoral artery access and concomitant prosthetic femorofemoral bypass, presented with an incarcerated, scrotal inguinal hernia...
January 8, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28064303/popliteal-artery-pseudoaneurysm-successfully-treated-with-amplatzer-vascular-plug
#11
K W Liew, B D K Leong
Popliteal artery pseudoaneurysm is uncommon. They usually result from penetrating or blunt trauma, arterial reconstructive surgery, invasive diagnostic or surgical orthopedic procedures. They can cause arterial thrombosis and limb ischeamia. We report a 53 year old Chinese gentleman with popliteal artery pseudoaneurysm who presented with right lower limb numbness and paralysis in toes extension. He gave a history of acupuncture treatment around the popliteal fossa of the affected limb. Clinical examination revealed a pulsatile mass in the popliteal fossa...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28063782/acceptable-clinical-outcomes-and-recommended-reconstructive-strategies-for-secondary-maxillary-reconstruction-with-vascularized-fibula-osteomyocutaneous-flap-a-retrospective-analysis
#12
Yi Shen, Jun Li, Andrew Ow, Liang Wang, Ming-Ming Lv, Jian Sun
BACKGROUND: We conducted a retrospective analysis of the clinical outcomes and evaluated the reconstructive strategies in patients who underwent secondary maxillary reconstruction with a vascularized fibula osteomyocutaneous flap (VFOF). METHODS: From May of 2001 to June of 2014, 34 patients who underwent secondary maxillary reconstruction with VFOF, with or without titanium mesh, were reviewed. The patients were divided into two groups of maxillary reconstruction, according to different planning and treatment strategies...
December 14, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#13
Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
PURPOSE: The advent of microvascular free tissue transfer has provided the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than 1 flap not only increases surgical complexity but also patient morbidity. The combination of the anterolateral thigh (ALT) flap and the tensor fascia latae (TFL) flap can be used to reconstruct such complex head and neck defects, thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site...
December 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28062176/characteristics-and-surgical-management-of-flap-compromise-caused-by-thrombosis-of-the-internal-jugular-vein
#14
Bin Yang, Yi Qu, Ming Su, Jinzhong Li, Hua Li, Rudong Xing, Zhengxue Han
BACKGROUND: A principal reason for flap compromise in oral and maxillofacial head and neck surgery, and failure of a free flap transfer, is thrombosis of a drainage vein such as the internal jugular vein. This study characterized flap compromise caused by internal jugular vein thrombosis after a free flap transfer, and its management. PATIENTS AND METHODS: A retrospective clinical study was conducted of 306 consecutive microvascular free flaps performed for 305 patients with head and neck cancer from March 2003 to March 2013 at the Department of Oral and Maxillofacial Surgery at Beijing Stomatological Hospital, Capital Medical University...
December 18, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28061548/suprafascial-harvest-of-the-radial-forearm-free-flap-decreases-the-risk-of-postoperative-tendon-exposure
#15
David C Shonka, Nikita V Kohli, Benjamin M Milam, Mark J Jameson
OBJECTIVE: To determine if suprafascial harvest of the radial forearm free flap improves postoperative donor site outcomes compared to subfascial harvest. METHODS: Retrospective chart review. RESULTS: Forty-six patients underwent reconstruction of a head and neck defect with a radial forearm free flap (RFFF). Subfascial harvest of the RFFF was performed in 25 (53%) patients and suprafascial harvest performed in 22 (47%) patients. All donor sites were covered with a split thickness skin graft and a bolster that remained in place for 6 days...
January 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#16
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28058213/face-transplantation-anesthetic-challenges
#17
REVIEW
Aparna Dalal
Face transplantation is a complex vascular composite allotransplantation (VCA) surgery. It involves multiple types of tissue, such as bone, muscles, blood vessels, nerves to be transferred from the donor to the recipient as one unit. VCAs were added to the definition of organs covered by the Organ Procurement and Transplantation Network Final Rule and National Organ Transplant Act. Prior to harvest of the face from the donor, a tracheostomy is usually performed. The osteotomies and dissection of the midface bony skeleton may involve severe hemorrhagic blood loss often requiring transfusion of blood products...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#18
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28052835/distraction-lengthening-following-vascularized-second-toe-transfer-for-isolated-middle-finger-reconstruction
#19
Jiuzhou Lu, Youlai Zhang, Junjiang Jiang, Lei Xu, Harvey Chim
PURPOSE: We report the use of distraction lengthening of the middle phalanx after vascularized second toe transfer for middle finger reconstruction to lengthen the digit to match the index and ring fingers. METHODS: We performed a retrospective review of 3 patients with a mean follow-up of 30 months. RESULTS: A mean increase of 2.0 cm in the length in the digit was achieved. The range of motion at the proximal interphalangeal joint was preserved and bony union was seen at the distraction site in all 3 cases...
January 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28051883/hydrogels-for-precision-meniscus-tissue-engineering-a-comprehensive-review
#20
Ana Rey-Rico, Magali Cucchiarini, Henning Madry
The meniscus plays a pivotal role to preserve the knee joint homeostasis. Lesions to the meniscus are frequent, have a reduced ability to heal, and may induce tibiofemoral osteoarthritis. Current reconstructive therapeutic options mainly focus on the treatment of lesions in the peripheral vascularized region. In contrast, few approaches are capable of stimulating repair of damaged meniscal tissue in the central, avascular portion. Tissue engineering approaches are of high interest to repair or replace damaged meniscus tissue in this area...
January 4, 2017: Connective Tissue Research
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