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Vascular reconstruction

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https://www.readbyqxmd.com/read/28340490/a-novel-method-of-neo-osseous-flap-prefabrication-induction-of-free-calvarial-periosteum-with-bioactive-glass
#1
Ali Aliyev, Omer Ekin, Ozan Bitik, Gokhan Tuncbilek
Background Reconstruction of craniofacial bone defects is a primary focus of craniofacial surgery. Although autogenous bone grafts remain as the gold standard, alloplastic materials have also gained widespread popularity due to their off-the-shelf availability, ease of use, and durability. In addition to replacing the missing bone, some of these alloplastic materials have also been found to induce new bone formation. Objectives In this study, the phenomenon of neo-osseous induction with bioactive glass was investigated for different implant-soft tissue configurations...
March 24, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28331452/balloon-occlusion-technique-for-managing-portal-vein-hemorrhage-in-liver-transplantation
#2
John B Seal, Humberto Bohorquez, Naren Battula, Lucia DeGregorio, Emily Bugeaud, David S Bruce, Ian C Carmody, Ari J Cohen, George E Loss
BACKGROUND: Portal vein thrombosis (PVT) is relatively common among candidates for liver transplantation and can present significant intraoperative challenges. Depending on the extent of PVT, thromboendovenectomy (TEV), portal bypass, or systemic inflow may be required to restore portal inflow. While TEV is the most commonly used approach to restore anatomic portal inflow, portal vein injury and life-threatening hemorrhage are risks with this technique. CASE REPORT: We present a salvage technique for managing portal vein injury during TEV using intraluminal balloon occlusion of the portal vein during portal vein repair and reconstruction...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28328655/vascularized-composite-allotransplantation-an-emerging-concept-for-burn-reconstruction
#3
Zhi Yang Ng, Alexandre G Lellouch, Tessa Drijkoningen, Irene A Chang, David H Sachs, Curtis L Cetrulo
Vascularized composite allotransplantation (VCA) has demonstrated utility in the reconstruction of extensive soft-tissue defects following severe burns. However, pre-VCA events such as multiple transfusions, previous transplantation and pregnancies, the use of skin allografts, and mechanical support devices may result in sensitization and ultimately exclude a burn patient, who may benefit most through VCA, from a hand or face transplant. The authors sought to identify the immunologic challenges involved. All reported VCA cases up to July 2016 were reviewed...
March 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28328603/simultaneous-autologus-mandible-and-temporomandibular-joint-reconstruction
#4
Yigit Ozer Tiftikcioglu, Ersin Gur, Ufuk Bilkay
Ablative surgery of mandible often necessitates combined reconstruction of the mandible and the temporomandibular joint. Fibula-free flaps with gap arthroplasty or osseochondral grafts are common procedures in the authors' practice. In search for a better reconstructive option free fibula flap is used together with a metatarsal bone flap for the vascular reconstruction of the mandibular body and the condyle at the same time. The 2 osseous-free flaps have been fused and used as a combined flow through double-free flap...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28327915/vascularized-fibular-strut-autografts-in-spinal-reconstruction-after-resection-of-vertebral-chordoma-or-chondrosarcoma-a-retrospective-series
#5
Vijay Yanamadala, Peter A Rozman, Jay I Kumar, Joseph H Schwab, Sang-Gil Lee, Francis J Hornicek, William T Curry
BACKGROUND: Margin-free en bloc resection is the best medical practice for primary vertebral chordoma and chondrosarcoma. Spinal reconstruction following total spondylectomy requires reconstructive interbody graft (allograft, devascularized autograft, vascularized autograft, or cage constructs) and instrumentation. An important consideration when choosing grafts and instrumentation is the durability and the long-term success of the fusion without subsidence. OBJECTIVE: To evaluate the potential use of vascularized fibular autograft as a reconstructive strategy after en bloc resection...
January 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28325443/vascular-segmentation-of-head-phase-contrast-magnetic-resonance-angiograms-using-grayscale-and-shape-features
#6
Ruoxiu Xiao, Hui Ding, Fangwen Zhai, Tong Zhao, Wenjing Zhou, Guangzhi Wang
BACKGROUND AND OBJECTIVE: In neurosurgery planning, vascular structures must be predetermined, which can guarantee the security of the operation carried out in the case of avoiding blood vessels. In this paper, an automatic algorithm of vascular segmentation, which combined the grayscale and shape features of the blood vessels, is proposed to extract 3D vascular structures from head phase-contrast magnetic resonance angiography dataset. METHODS: First, a cost function of mis-segmentation is introduced on the basis of traditional Bayesian statistical classification, and the blood vessel of weak grayscale that tended to be misclassified into background will be preserved...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28324141/early-hepatic-artery-thrombosis-after-liver-transplantation-what-is-the-impact-of-the-arterial-reconstruction-type
#7
Astrid Herrero, Regis Souche, Emmanuel Joly, Gildas Boisset, Hussein Habibeh, Hassan Bouyabrine, Fabrizio Panaro, Jose Ursic-Bedoya, Samir Jaber, Boris Guiu, Georges Philippe Pageaux, Francis Navarro
OBJECTIVE: Hepatic artery thrombosis (HAT) is the most severe vascular complication occurring after liver transplantation, with an incidence ranging from 2 to 9% in adults. Although the ideal arterial reconstruction is often described as a short and non-redundant anastomosis fashioned between the recipient and donor hepatic arteries, there is no strong evidence about this ideal reconstruction in the literature. The aim of this study was to assess the impact of the type of arterial reconstruction on early HAT after primary liver transplantation...
March 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28323545/creation-of-a-bioengineered-skin-flap-scaffold-with-a-perfusable-vascular-pedicle
#8
Bernhard J Jank, Jeremy Goverman, Jacques P Guyette, Jon M Charest, Mark A Randolph, Glenn R Gaudette, Joshua R Gershlak, Martin Purschke, Emilia Javorsky, Rosalynn M Nazarian, David A Leonard, Curtis L Cetrulo, William G Austen, Harald Christian Ott
Full thickness skin loss is a challenging problem due to limited reconstructive options, demanding 75 million surgical procedures annually in the United States. Autologous skin grafting is the gold standard treatment, but results in donor site morbidity and poor aesthetics. Numerous skin substitutes are available on the market to date, however, none truly function as full thickness skin due to their lack of a vascular network. The creation of an autologous full thickness skin analogue with a vascular pedicle would result in a paradigm shift in the management of wounds and in reconstruction of full thickness skin defects...
March 21, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28323157/anatomic-variations-of-inferior-mesenteric-artery-and-left-colic-artery-evaluated-by-3-dimensional-ct-angiography-insights-into-rectal-cancer-surgery
#9
Jia Ke, Jiawei Cai, Xiaofeng Wen, Xianrui Wu, Zhen He, Yifeng Zou, Jianping Qiu, Xiaowen He, Xiaosheng He, Lei Lian, Xiaojian Wu, Zhiyang Zhou, Ping Lan
OBJECTIVE: To demonstrate the clinical applicability of 3-dimensional CT angiography (3D-CTA) in evaluating the anatomic variations of inferior mesenteric artery (IMA) and left colic artery (LCA), to help make pre-operative strategies of rectal cancer surgery. METHODS: 188 patients with abdominal and pelvic contrast-enhanced CT scan were retrospectively enrolled and 3D-CTA was reconstructed. The origin and branching patterns of IMA, tracking patterns of LCA, intersectional patterns among IMA, LCA and inferior mesenteric vein (IMV) were examined, and their associations with clinical features were analyzed...
March 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28322621/bladder-regeneration-using-multiple-scaffolds-with-growth-factors-in-a-bladder
#10
Luc A J Roelofs, Paul K J D de Jonge, Egbert Oosterwijk, Dorien M Tiemessen, Barbara B Kortmann, Robert P E de Gier, Elly M M Versteeg, Willeke F Daamen, Toin H van Kuppevelt, Paul J Geutjes, Wout Feitz
INTRODUCTION: Tissue engineering may become an alternative to current bladder augmentation techniques. Large scaffolds are needed for clinically significant augmentation, but can result in fibrosis and graft shrinkage. The purpose of this study was to investigate the use of multiple scaffolds instead of one large scaffold, to enhance bladder tissue regeneration and bladder capacity. Secondly, acellular collagen, collagen-heparin, and collagen-heparin scaffolds with growth factors were used and the biological activity of the different scaffolds was compared in a large animal model...
March 21, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28322040/design-and-fabrication-of-a-thin-walled-freeform-scaffold-on-the-basis-of-medical-image-data-and-a-3d-printed-template-potential-use-in-bile-duct-regeneration
#11
Suk Hee Park, Bo-Kyeong Kang, Ji Eun Lee, Seung Woo Chun, Kiseok Jang, Youn Hwan Kim, Mi Ae Jeong, Yohan Kim, Kyo Jin Kang, Nak Kyu Lee, Dongho Choi, Han Joon Kim
Three-dimensional (3D) printing, combined with medical imaging technologies, such as computed tomography (CT) and magnetic resonance imaging (MRI), has shown great potential in patient-specific tissue regeneration. Here, we successfully fabricated an ultrathin tubular freeform structure that has a wall thickness of several tens of micrometers and is capable of providing sufficient mechanical flexibility. Such a thin geometry cannot easily be achieved by 3D printing alone; therefore, it was realized through a serial combination of processes that included the 3D printing of a sacrificial template, the dip-coating of the biomaterial, and the removal of the inner template...
March 21, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28321378/hemi-transseptal-approach-for-pituitary-surgery-a-follow-up-study
#12
Naif Fnais, Salvatore Di Maio, Susan Edionwe, Anthony Zeitouni, Denis Sirhan, Constanza J Valdes, Marc A Tewfik
Objectives The hemi-transseptal (Hemi-T) approach was developed to overcome the potential drawbacks of the nasoseptal flap (NSF) in endoscopic endonasal transsphenoidal skull base surgery. In this study, we describe further refinements on the Hemi-T approach, and report long-term outcomes as compared with traditional methods of skull base reconstruction. Design A retrospective case-control study. Setting Montreal Neurological Institute and Jewish General Hospital, Montreal, Canada. Participants Patients who underwent endoscopic endonasal transsphenoidal approach to skull base pathology...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321377/single-layer-repair-of-large-anterior-skull-base-defects-without-vascularized-mucosal-flap
#13
Frederick Yoo, Marilene B Wang, Marvin Bergsneider, Jeffrey D Suh
Objectives Bilateral anterior skull base (ASB) defects following endoscopic endonasal tumor resection are most commonly repaired utilizing multilayered reconstruction with a vascularized mucosal flap. Single-layer closure of large ASB defects has been described in the literature but this technique has yet to gain a widespread use. We report our experience with a series of patients who underwent reconstruction of large ASB defects using a single-layer intradural graft, without nasoseptal flaps. We also compared the use of acellular dermal matrix (AlloDerm, LifeCell, Branchburg, New Jersey, United States) or collagen matrix xenograft (Duramatrix, Stryker, Kalamazoo, Michigan, United States) as the graft biomaterial...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28320612/three-dimensional-image-fusion-of-18-f-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-and-contrast-enhanced-computed-tomography-for-computer-assisted-planning-of-maxillectomy-of-recurrent-maxillary-squamous-cell-carcinoma-and-defect-reconstruction
#14
Yao Yu, Wen-Bo Zhang, Xiao-Jing Liu, Chuan-Bin Guo, Guang-Yan Yu, Xin Peng
PURPOSE: The purpose of this study was to describe new technology assisted by 3-dimensional (3D) image fusion of (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) for computer planning of a maxillectomy of recurrent maxillary squamous cell carcinoma and defect reconstruction. MATERIALS AND METHODS: Treatment of recurrent maxillary squamous cell carcinoma usually includes tumor resection and free flap reconstruction...
February 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28319440/markers-of-blood-coagulation-and-fibrinolysis-in-patients-with-early-and-delayed-microsurgical-reconstructions-in-the-lower-extremities
#15
Oliver Kloeters, Dalibor Vasilic, Pieter Hupkens, Dietmar Ulrich
BACKGROUND: In this study, markers of coagulation and fibrinolysis were assessed during early and delayed microsurgical reconstruction in patients with traumatic defects of their lower legs to analyse whether an imbalance of the hemostasis after trauma might predispose the development of vascular complications. METHODS: The prospective study included 70 patients. In 35 patients, surgery was performed within 72 hours after injury. In 35 other patients, delayed free flap transfer was performed between 14-21 days after trauma...
March 20, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#16
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28315184/epiphyseal-arterial-network-and-inferior-retinacular-artery-seem-critical-to-femoral-head-perfusion-in-adults-with-femoral-neck-fractures
#17
Dewei Zhao, Xing Qiu, Benjie Wang, Zihua Wang, Wei Wang, Jun Ouyang, Rona M Silva, Xiaotian Shi, Kai Kang, Dachuan Xu, Chuang Li, Shizhen Zhong, Yu Zhang, Kent E Pinkerton
BACKGROUND: A better understanding of the blood supply of the femoral head is essential to guide therapeutic strategies for patients with femoral neck fractures. However, because of the limitations of conventional techniques, the precise distribution and characteristics of intraosseous arteries of the femoral head are not well displayed. QUESTIONS/PURPOSES: To explore the characteristics and interconnections of the intraosseous vessel system between different areas of the femoral head and the possible blood supply compensatory mechanism after femoral neck fracture...
March 17, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28300924/staged-retroauricular-flap-for-helical-reconstruction-after-mohs-micrographic-surgery
#18
Felipe Bochnia Cerci
Staged retroauricular flap is a great option for full-thickness defects along the helical rim and antihelix. Donor site consists of the posterior ear, postauricular sulcus and mastoid area. The advantages of this flap include hidden donor scar, donor tissue similarity and rich vascularity. We present a case of collision tumor on the left helix treated with Mohs micrographic surgery and the resulting full-thickness defect repaired with a staged retroauricular flap. This flap is an effective technique for full-thickness helical defect repair with relatively little operative morbidity...
September 2016: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28300738/preliminary-results-from-the-comparison-of-simple-limbal-epithelial-transplantation-with-conjunctival-limbal-autologous-transplantation-in-severe-unilateral-chronic-ocular-burns
#19
Ritu Arora, Pallavi Dokania, Aditi Manudhane, Jawahar Lal Goyal
PURPOSE: To compare the safety, efficacy, and clinical outcomes of simple limbal epithelial transplantation (SLET) with conjunctival-limbal autologous transplantation (CLAU) in severe unilateral ocular chemical burns. MATERIALS AND METHODS: Twenty patients of unilateral chronic ocular burns with more than 270° limbal stem cell deficiency and a healthy fellow eye were divided into two groups - ten patients of Group A underwent SLET while ten patients of Group B were operated for CLAU...
January 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28296812/pedicled-vascularized-clavicular-graft-for-anterior-cervical-arthrodesis-cadaveric-feasibility-study-technique-description-and-case-report
#20
Michael A Bohl, Michael A Mooney, Joshua S Catapano, Kaith K Almefty, Mark C Preul, Steve W Chang, U Kumar Kakarla, Edward M Reece, Jay D Turner, Randall W Porter
STUDY DESIGN: Cadaveric feasibility study. OBJECTIVES: To assess the anatomic and technical feasibility of rotating a clavicular segment on a sternocleidomastoid muscle (SCM) pedicle into the ventral cervical spine using a cadaveric model and to provide the first clinical case description of performing this procedure. SUMMARY OF BACKGROUND DATA: Reconstruction of the anterior cervical spine in patients with a high risk of pseudoarthrosis may require the use of a vascularized bone graft (VBG)...
March 14, 2017: Spine
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