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Microvascular anastomosis

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https://www.readbyqxmd.com/read/29672777/diep-flap-breast-reconstruction-complication-rate-in-previously-irradiated-internal-mammary-nodes
#1
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
#2
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
#3
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...
April 13, 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
#4
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
#5
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)...
March 22, 2018: Microvascular Research
https://www.readbyqxmd.com/read/29554789/impact-of-visualization-on-simulation-training-for-vascular-anastomosis
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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...
February 20, 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
#12
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
https://www.readbyqxmd.com/read/29432617/outcomes-following-coronary-artery-bypass-grafting-with-microsurgery-in-paediatric-patients
#13
Mark S Shafarenko, Joseph Catapano, Shuhua Luo, Ronald M Zuker, Glen Van Arsdell, Gregory H Borschel
OBJECTIVES: Paediatric coronary artery bypass grafting is indicated in cases of clinically significant and symptomatic coronary stenosis, with frequent complications occurring in the perioperative period. To reduce complications and improve outcomes of these procedures, surgical microscopes have been used at our centre with the anastomosis performed by a microvascular surgeon. The purpose of this article is to report our institutional experience in all patients who have undergone paediatric coronary artery bypass grafting procedures with and without microvascular techniques...
February 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29328540/case-of-late-onset-relapsing-surgical-site-infection-related-to-a-venous-coupler-placed-during-free-flap-reconstruction-for-major-head-and-neck-cancer
#14
Yin Ren, Daniel G Deschler, Dipti Sajed, Marlene L Durand
BACKGROUND: Venous coupling devices are widely used during reconstructive surgery involving microvascular anastomosis but have not served as foreign bodies in head and neck surgical site infections. METHODS: We conducted a case report. RESULTS: A patient underwent resection and free flap reconstruction for recurrent tongue squamous cell carcinoma. She developed a neck abscess due to Streptococcus intermedius 7 weeks postoperatively, days after starting chemoradiotherapy...
April 2018: Head & Neck
https://www.readbyqxmd.com/read/29322547/improvement-of-the-salvage-rate-of-flap-after-venous-thrombosis-with-intraparenchymatous-venous-pressure-monitoring
#15
Hajime Matsumine, Mariko Mogami, Osamu Fujiwara, Masahiro Hasegawa, Hiroshi Ito, Hiroyuki Sakurai
PURPOSE: Intraparenchymatous venous pressure (IVP) monitoring in flap can measure venous pressure with catheter placement. Among patients with IVP monitoring, this study reviewed postoperative microvascular complications for investigating the transplanted-tissue salvage-rate. PATIENTS AND METHODS: Two hundred and seventy-one patients (male, 132; female, 139; mean age, 52.3 years; age range, 9-82 years) underwent free flap transfer and postoperative continuous IVP monitoring, which performed as follows; a venous catheter was connected to a transducer, and venous pressure in the flap was recorded for three consecutive days postoperatively...
January 11, 2018: Microsurgery
https://www.readbyqxmd.com/read/29309665/running-to-interrupted-microsuture-technique-for-vascular-bypass
#16
Robert C Rennert, Ben A Strickland, Ryan E Radwanski, Kristine Ravina, Mark Chien, Jonathan J Russin
BACKGROUND: The ideal suturing technique for microvascular anastomosis for neurosurgical bypass procedures remains a point of debate. Simple interrupted sutures are thought to possess higher long-term patency but require more time to place as compared to running sutures. OBJECTIVE: To optimize the efficiency of microvascular anastomosis and limit brain ischemia time. METHODS: The running-to-interrupted microsuture technique, a modification of the previously published spiral anastomosis, is described wherein loosely thrown running sutures are placed between 2 opposed anchor stitches...
December 21, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29299526/chicken-thigh-microvascular-training-model-improves-resident-surgical-skills
#17
Francis X Creighton, Allen L Feng, Neerav Goyal, Kevin Emerick, Daniel Deschler
Objectives: Microsurgical techniques are essential for vessel anastomosis in free flap reconstructive surgery. However, teaching these skills intraoperatively is difficult. The chicken thigh microvascular model is a high-fidelity model that has been previously validated to differentiate between skill levels of surgeons. This study aims to determine if this model objectively improves microsurgical skills. Study Design: Validation study. Methods: Thirteen residents were given a tutorial on microvascular anastomosis and asked to perform anastomoses on the microvascular model...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29284163/geometric-three-dimensional-end-to-side-microvascular-anastomosis-a-simple-and-reproducible-technique
#18
Adrian S H Ooi, Daniel R Butz, Sean M Fisher, Zachary J Collier, Lawrence J Gottlieb
BACKGROUND:  End-to-side (ETS) anastomoses are useful when preservation of distal vascularity is critical. The ideal ETS microanastomosis should maintain a wide aperture and have a smooth take-off point to minimize turbulence, vessel spasm, and thrombogenicity of the suture line. We have developed a unique, dependable, and reproducible geometric technique for ETS anastomoses, and analyze its efficacy in our series of patients. METHODS:  The geometric ETS technique involves creating a three-dimensional (3D) diamond-shaped defect on the recipient vessel wall, followed by a slit incision of the donor vessel to create a "spatula" fitting this defect...
December 28, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29243415/compact-dual-mode-diffuse-optical-system-for-blood-perfusion-monitoring-in-a-porcine-model-of-microvascular-tissue-flaps
#19
Seung Yup Lee, Julia M Pakela, Michael C Helton, Karthik Vishwanath, Yooree G Chung, Noah J Kolodziejski, Christopher J Stapels, Daniel R McAdams, Daniel E Fernandez, James F Christian, Jameson O'Reilly, Dana Farkas, Brent B Ward, Stephen E Feinberg, Mary-Ann Mycek
In reconstructive surgery, the ability to detect blood flow interruptions to grafted tissue represents a critical step in preventing postsurgical complications. We have developed and pilot tested a compact, fiber-based device that combines two complimentary modalities-diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy-to quantitatively monitor blood perfusion. We present a proof-of-concept study on an in vivo porcine model (n=8). With a controllable arterial blood flow supply, occlusion studies (n=4) were performed on surgically isolated free flaps while the device simultaneously monitored blood flow through the supplying artery as well as flap perfusion from three orientations: the distal side of the flap and two transdermal channels...
December 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29187756/pilot-study-on-microvascular-anastomosis-performance-and-future-educational-prospects
#20
G Berretti, G Colletti, G Parrinello, A Iavarone, P Vannucchi, A Deganello
The introduction of microvascular free flaps has revolutionised modern reconstructive surgery. Unfortunately, access to training opportunities at standardised training courses is limited and expensive. We designed a pilot study on microvascular anastomoses with the aim of verifying if a short course, easily reproducible, could transmit microvascular skills to participants; if the chosen pre-test was predictive of final performance; and if age could influence the outcome. A total of 30 participants (10 students, 10 residents and 10 surgeons) without any previous microvascular experience were instructed and tested during a single 3 to 5 hour course...
November 30, 2017: Acta Otorhinolaryngologica Italica
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