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Microvascular anastomosis

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https://www.readbyqxmd.com/read/29906811/comparison-of-hand-sewn-versus-coupled-venous-anastomoses-in-traumatic-lower-extremity-reconstruction
#1
John T Stranix, William J Rifkin, Z-Hye Lee, Lavinia Anzai, Adam Jacoby, Daniel J Ceradini, Vishal Thanik, Pierre B Saadeh, Jamie P Levine
BACKGROUND:  Microvascular reconstruction of the lower extremity has the highest reported complication and flap failure rates of any anatomical region. Despite widespread adoption of the mechanical anastomotic venous coupler and encouraging results in other anatomical regions, there are limited reports examining its use in the lower extremity. This study compares outcomes between coupled and hand-sewn venous anastomoses in traumatic lower extremity reconstruction. METHODS:  Retrospective review of our institutional flap registry from 1979 to 2016 identified soft tissue free flaps performed for the reconstruction of Gustilo type IIIB/IIIC open tibial fractures...
June 15, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29806328/-modified-anterolateral-thigh-perforator-flap-pedicled-by-cross-bridge-microvascular-anastomosis-for-repairing-soft-tissue-defects-in-middle-and-lower-segments-of-leg
#2
Lin Yang, Hongjun Liu, Wenzhong Zhang, Guoxun Song, Shicong Xia, Naichen Zhang, Jiaxiang Gu, Chaoqun Yuan
Objective: To explore the effectiveness of modified anterolateral thigh perforator flap pedicled by cross-bridge microvascular anastomosis in treatment of soft tissue defects in the middle and lower segments of the leg. Methods: Between March 2011 and June 2015, 15 cases with skin and soft tissue defects in the middle and lower segments of the legs were treated. There were 9 males and 6 females, aged 22-48 years (mean, 32.6 years). Of whom, 8 patients caused by traffic accidents, 5 by machine twist, and 2 by crash injury of heavy object...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29796313/microvascular-anastomosis-training-in-neurosurgery-a-review
#3
REVIEW
Vadim A Byvaltsev, Serik K Akshulakov, Roman A Polkin, Sergey V Ochkal, Ivan A Stepanov, Yerbol T Makhambetov, Talgat T Kerimbayev, Michael Staren, Evgenii Belykh, Mark C Preul
Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques...
2018: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/29762453/microvascular-replantation-following-facial-dog-bites-in-children-systematic-review-and-management-algorithm
#4
Amanda J Williams, Jeremy M Powers, Jennifer L Rhodes, Andrea L Pozez
BACKGROUND: Pediatric dog bite injuries account for 1% of emergency department visits per year and represent an underrecognized and underreported public health problem. Reconstructive surgery is frequently utilized, and in the most extreme injuries, microvascular replantation may be considered. We sought to systematically review the available literature on microvascular replantation after facial dog bite injuries in children, with particular attention to perioperative morbidity and long-term follow-up...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29753503/novel-esophageal-reconstruction-technique-via-transmediastinal-route-from-posterior-to-anterior-mediastinum-after-esophagectomy
#5
Takushi Yasuda, Osamu Shiraishi, Mitsuru Iwama, Tomoki Makino, Hiroaki Kato, Yutaka Kimura
BACKGROUND: The incidence of metachronous esophageal squamous cell cancer (ESCC) after head and neck cancer (HNC) and in elderly patients has increased. Both elderly ESCC patients and ESCC patients after HNC surgery are at potential risk for dysphagia, and for the latter, surgery in the neck is difficult. An intrathoracic anastomosis that bypasses the cervical procedure is preferable to preserve swallowing function and reduce surgical risk. In gastrectomized patients, because the stomach cannot be used as a substitute, securing graft blood supply is critical, but microvascular anastomosis cannot be easily added in procedures for intrathoracic posterior mediastinal reconstruction...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29747901/use-of-a-microvascular-coupler-device-for-end-to-side-venous-anastomosis-in-oral-and-maxillofacial-reconstruction
#6
W-M Wang, L Huang, X Gao, Y-X Yuan, X-Q Chen, X-C Jian
The aim of this study was to compare the use of a microvascular coupler device (MCD) for end-to-side venous anastomosis (ETS group) and phleboplasties combined with MCD for end-to-end venous anastomosis (ETE group) in free tissue transfer for oral and maxillofacial reconstruction, with regard to the anastomosis time and occurrence of postoperative vascular crisis. The ETS group included 22 patients and the ETE group included 40 patients. Patient demographic data, anastomotic time, coupler size, microvascular complications, and flap survival rates were collected and analyzed...
May 7, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29729609/virtual-surgical-planning-and-three-dimensional-printing-in-multidisciplinary-oncologic-chest-wall-resection-and-reconstruction-a-case-report
#7
Basel Sharaf, M Diya Sabbagh, Aparna Vijayasekaran, Mark Allen, Jane Matsumoto
INTRODUCTION: Primary sarcomas of the sternum are extremely rare and present the surgical teams involved with unique challenges. Historically, local muscle flaps have been utilized to reconstruct the resulting defect. However, when the resulting oncologic defect is larger than anticipated, local tissues have been radiated, or when preservation of chest wall muscles is necessary to optimize function, local reconstructive options are unsuitable. PRESENTATION OF CASE: Virtual surgical planning (VSP) and in house three-dimensional (3D) printing provides the platform for improved understanding of the anatomy of complex tumours, communication amongst surgeons, and meticulous pre-operative planning...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29701760/optical-techniques-for-perfusion-monitoring-of-the-gastric-tube-after-esophagectomy-a-review-of-technologies-and-thresholds
#8
S M Jansen, D M de Bruin, M I van Berge Henegouwen, S D Strackee, D P Veelo, T G van Leeuwen, S S Gisbertz
Anastomotic leakage is one of the most severe complications after esophageal resection with gastric tube reconstruction. Impaired perfusion of the gastric fundus is seen as the main contributing factor for this complication. Optical modalities show potential in recognizing compromised perfusion in real time, when ischemia is still reversible. This review provides an overview of optical techniques with the aim to evaluate the (1) quantitative measurement of change in perfusion in gastric tube reconstruction and (2) to test which parameters are the most predictive for anastomotic leakage...
April 26, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29672777/diep-flap-breast-reconstruction-complication-rate-in-previously-irradiated-internal-mammary-nodes
#9
Shirley Shechter, Ehud Arad, Amir Inbal, Or Friedman, Eyal Gur, Yoav Barnea
BACKGROUND:  Postmastectomy radiation therapy (PMRT) is a widely accepted treatment for locally advanced breast cancer. Some patients require additional boost radiation to the internal mammary nodes as the part of regional nodal irradiation (RNI). Delayed breast reconstruction with an autologous free flap using the internal mammary vessels for microvascular flap anastomosis is a common practice for these patients. The aim of our study was to evaluate the effect of RNI on autologous microvascular breast reconstruction...
April 19, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29669067/microvascular-anastomosis-proposition-of-a-learning-curve
#10
Pooneh Mokhtari, Ali Tayebi Meybodi, Arnau Benet, Michael T Lawton
BACKGROUND: Learning to perform a microvascular anastomosis is one of the most difficult tasks in cerebrovascular surgery. Previous studies offer little regarding the optimal protocols to maximize learning efficiency. This failure stems mainly from lack of knowledge about the learning curve of this task. OBJECTIVE: To delineate this learning curve and provide information about its various features including acquisition, improvement, consistency, stability, and recall...
April 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29661648/one-year-rat-study-of-ibta-induced-microbiotube-microvascular-grafts-with-an-ultra-small-diameter-of-0-6-mm
#11
Daizo Ishii, Jun-Ichiro Enmi, Ryosuke Iwai, Kaoru Kurisu, Eisuke Tatsumi, Yasuhide Nakayama
OBJECTIVE: The world's smallest calibre "microbiotube" vascular graft was recently developed, with an inner diameter of 0.6 mm. It was formed using in-body tissue architecture (iBTA) and has a high degree of patency and capacity for regeneration in the acute phase, 1 month after implantation. This consecutive study investigated the compatibility and stability of microbiotubes in the chronic phase of implantation for 12 months for potential application in microsurgery. METHODS: This was an in vivo experimental study...
June 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29618068/occipital-artery-to-posterior-cerebral-artery-bypass-using-descending-branch-of-the-lateral-circumflex-femoral-artery-graft-for-treatment-of-fusiform-unruptured-posterior-cerebral-artery-aneurysm-3-dimensional-operative-video
#12
Kristine Ravina, Ian A Buchanan, Robert C Rennert, Ben A Strickland, Joseph N Carey, Jonathan J Russin
Posterior cerebral artery (PCA) aneurysms can be technically challenging lesions due to the intricacy of perforating branches and the relationship to cranial nerves and the brainstem. Fusiform aneurysms of the perimesencephalic segment of the PCA are a rare finding which does not favor direct clip occlusion or reconstruction. In such cases, proximal parent vessel occlusion is an option for aneurysm treatment. Extracranial-intracranial (EC-IC) bypass can be used to revascularize beyond the lesion when considering proximal occlusion...
April 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29577940/vascular-architecture-in-free-flaps-analysis-of-vessel-morphology-and-morphometry-in-murine-free-flaps
#13
Andreas Max Pabst, Peer Wolfgang Kämmerer, Maximilian Krüger, Lukas Jäger, Maximilian Ackermann
The aim of this study was to analyze the development of vascular architecture as well as vascular morphometry and morphology of anastomosed microvascular free flaps. Free pectoral skin flaps were raised in 25 rats and anastomosed to the femoral vessels in the groin region. CD31 immunohistology was performed after 3, 7 and 12 d (each 5 animals each) to analyze microvessel density (MVD), microvessel area (MVA) and microvessel size (MVS). Microvascular corrosion casting was performed after 7 and 12 d (5 animals each) to analyze vessel diameter (VD), intervascular distance (IVD), interbranching distance (IBD), and branching angle (BA)...
July 2018: Microvascular Research
https://www.readbyqxmd.com/read/29554789/impact-of-visualization-on-simulation-training-for-vascular-anastomosis
#14
Tarek Malas, Talal Al-Atassi, Tim Brandys, Viren Naik, Harry Lapierre, Buu-Khanh Lam
OBJECTIVE: There is mounting evidence supporting the benefit of surgical simulation on the learning of skills independently and in a patient-safe environment. The objective of this study was to examine the effect of visualization of surgical steps via instructional media on performance of an end-to-side microvascular anastomosis. METHODS: Thirty-two first- and second-year surgical trainees from the University of Ottawa received an expert-guided, didactic lecture on vascular anastomosis and performed an end-to-side anastomosis on a procedural model to assess baseline skills...
April 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29464172/free-flap-survival-despite-internal-jugular-vein-thrombosis-in-head-and-neck-reconstruction
#15
Koichiro Kiya, Tateki Kubo, Shien Seike, Ko Hosokawa
Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29464166/successful-hand-replantation-in-a-case-of-total-avulsion-without-vein-graft
#16
Shatha M Sulaiman, Abdulmalik A Alkhodair, Shahd M Sulaiman, Lama M Sulaiman, Ahmed S Elkafafy
Replantation is the reattachment of a severed body part, with attempts to restore neurovascular and musculoskeletal integrity, function, and aesthetics. On September 7, 1964, the first extremity replantation-a completely amputated hand-by vascular anastomosis technique was successfully performed.1 Soon after, the first replantation of a complete thumb amputation using microvascular anastomosis in a human was successfully conducted by Komatsu et al.2 in 1968. The overall success rate of limb replantation surgery is around 83...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29462373/the-role-of-matrix-metalloproteinase-3-in-the-doxycycline-attenuation-of-intracranial-venous-hypertension-induced-angiogenesis
#17
Xiang Zou, Zehan Wu, Jun Huang, Peixi Liu, Xuanfeng Qin, Liang Chen, Wei Zhu, Yao Zhao, Peiliang Li, Jianping Song, Guo-Yuan Yang, Ying Mao
BACKGROUND: The molecular mechanism of brain arteriovenous malformation (BAVM) is largely unknown. Intracranial venous hypertension (VH) may enhance focal angiogenesis and promote BAVM development and progression. A rat VH model effectively simulates the hemodynamic microenvironment of this disease. OBJECTIVE: To explore the effect of doxycycline in VH-related angiogenesis, as well as the role of matrix metalloproteinase-3 (MMP-3) and other molecular factors. METHODS: A rat VH model was generated by common carotid artery and distal external jugular vein anastomosis...
February 16, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29461294/basic-microvascular-anastomosis-simulation-hub-microsurgery-course-an-innovative-competency-based-approach-to-microsurgical-training-for-early-year-s-plastic-surgery-trainees
#18
Stephen Ali
Early year's plastic surgery trainees are faced with a large choice of microsurgery courses to select from. In the context of dwindling study budgets and busy on-call rotas, the pressure to select a high yield course that delivers value for money is of paramount importance.The Basic Microvascular Anastomosis Simulation Hub Microsurgery Course is a GBP £600 (US $790) 5-day 40-hour course based at Barts and The London School of Medicine and Dentistry increasing in popularity among junior trainees to fit this brief...
April 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29461035/heparin-eluting-electrospun-nanofiber-yarns-for-antithrombotic-vascular-sutures
#19
Sooneon Bae, Michael J DiBalsi, Nicole Meilinger, Chengqi Zhang, Erica Beal, Guzeliya Korneva, Robert O Brown, Konstantin G Kornev, Jeoung Soo Lee
The surgical connection of blood vessels, anastomosis, is a critical procedure in many reparative, transplantation, and reconstructive surgical procedures. However, effective restoration of circulation is complicated by pathological clotting (thrombosis) or progressive occlusion due to excess cell proliferation that often leads to additional surgeries and increases morbidity and mortality risk for patients. Pharmaceutical agents have been tested to prevent these complications, but many have unacceptable systemic side effects...
March 14, 2018: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29452442/simplifying-arterial-coupling-in-microsurgery-a-preclinical-assessment-of-an-everter-device-to-aid-with-arterial-anastomosis
#20
Ian C Sando, Jeffrey S Plott, Brendan M McCracken, Mohamad H Tiba, Kevin R Ward, Jeffrey H Kozlow, Paul S Cederna, Adeyiza O Momoh
BACKGROUND:  A novel arterial everter device was engineered to simplify microvascular coupling of arteries by reliably securing the stiff, muscular wall of arteries over coupler pins. We compare microvascular coupling with the everter device to manual suturing for arterial anastomoses in a live large animal model. METHODS:  In this preliminary study, bilateral external femoral arteries of five male swine were exposed and sharply divided. Arteries were anastomosed using either interrupted sutures ( n  = 5) or the everter device and Synovis Coupler ( n  = 5)...
February 16, 2018: Journal of Reconstructive Microsurgery
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