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vascular anastomosis

Alexandre Morel, Michel Rivoire, Valéria Basso, Pierre Meeus, Patrice Peyrat, Aurélien Dupré
PURPOSE: Knowledge of vascular outflow is essential in liver surgery. Communicating veins between the right hepatic vein (RHV) and the middle hepatic vein (MHV) have been described and allowed us to perform new surgical procedures. The aim of this study was to predict the existence of intra-hepatic venous anastomosis by identifying communicating veins on 2D CT-scan imaging. METHODS: We retrospectively analysed data from 32 patients operated on for liver tumours between 2004 and 2013 who underwent a bisegmentectomy VI-VII enlarged to the RHV and/or a bisegmentectomy VII-VIII and/or a left hepatectomy enlarged to the MHV and who had pre and post-operative CT-scans...
October 25, 2016: Surgical and Radiologic Anatomy: SRA
Eugene Wang, Kenji Inaba, Jayun Cho, Saskya Byerly, Vincent Rowe, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
Thrombosis is a devastating complication after repair of traumatic vascular injury. Although thrombosis rates have been described, the value of anticoagulation in preventing postrepair thrombosis is unknown. We hypothesize that postoperative anticoagulation reduces thrombosis rates. A total of 1524 consecutive patients with traumatic arterial injuries from January 2005 to June 2015 were identified, and 381 patients underwent the following repair types: direct suture of vessel wall, primary anastomosis, extra-anatomic reconstruction, tissue and synthetic interposition reconstruction...
October 2016: American Surgeon
C W Michalski, P Tramelli, M W Büchler, T Hackert
Postoperative pancreatic fistulas represent the most frequent complication after distal and segmental pancreatectomy and occur with a frequency of up to 50 %. There are many technical variations of pancreatic stump treatment for reduction of fistula rates after distal resection. Most of these techniques have only been analyzed in retrospective studies and the evidence for or against a specific technique is low. Several retrospective trials have been conducted with good results to compare suturing with stapled closure of the remnant and to assess the effect of a vascularized falciform ligament patch in reducing postoperative pancreatic fistula; however, in a recently published randomized trial, which analyzed closure of the remnant with a pancreaticojejunostomy compared to standard closure, these results could not be confirmed...
October 24, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Masao Takahashi, Akira Uchino, Chihiro Suzuki
The accessory middle cerebral artery (MCA) is a common variation of the MCA that arises from the anterior cerebral artery. We report a patient with anastomosis of the accessory MCA with the main MCA, an extremely rare variant that we diagnosed by magnetic resonance (MR) angiography. Both partial maximum-intensity-projection and partial volume-rendering MR angiographic images obtained at 3 T are useful to identify such rare vascular variation.
October 22, 2016: Surgical and Radiologic Anatomy: SRA
Anders J Davidson, Lucas P Neff, Joseph J DuBose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow but require additional vascular intervention and risk shunt thrombosis with prolonged use...
November 2016: Journal of Trauma and Acute Care Surgery
Terry C Lairmore
BACKGROUND: The last 200 years have seen remarkable achievements in the art and clinical practice of surgery. These advances include the introduction of antisepsis, anesthesia, vascular anastomosis, antimicrobials, organ transplantation, and the widespread application of minimally invasive operative procedures. Very recently, a surgical procedure has been shown to cure diabetes, representing the most effective treatment of a metabolic disorder by surgeons. METHODS: The author reviewed the major surgical milestones in the modern surgical era and prepared this monograph for presentation as the Claude H...
September 30, 2016: American Journal of Surgery
Nupur Pruthi, Pragyan Sarma, Paritosh Pandey
AIM: To practice various anastomotic techniques using rat femoral vessels and study the patency rates. MATERIAL AND METHODS: Sixty four Sprague-dawley rats were used in the study. Following procedures were conducted on Rat femoral vessels: femoral artery end to end anastomosis- classical method, one way up method, femoral vein end to end anastomosis and end to side anastomosis. The animals were subsequently sacrificed at a later date to assess delayed patency. RESULTS: The immediate patency rates for femoral artery end to end anastomosis- classical method (n=10), one way up method (n=16), femoral vein end to end anastomosis (n=12) and end to side anastomosis (n=26) were 100%, 81...
September 9, 2016: Turkish Neurosurgery
Robert N Goldstone, Michael C McCormack, Rachel L Goldstein, Srivalleesha Mallidi, Mark A Randolph, Michael T Watkins, Robert W Redmond, William G Austen
OBJECTIVE: We hypothesized that decreasing vein compliance would protect the vein against stretch injury and reduce intimal hyperplasia (IH). BACKGROUND: Although arteriovenous fistulas (AVFs) are the criterion standard for vascular access, their effectiveness is limited by poor patency with 40% to 60% failing due to IH. Venous stretch injury from exposure to arterial pressure induces IH. Photochemical tissue passivation (PTP) crosslinks adventitial collagen, decreasing vein compliance to resemble that of an artery...
October 17, 2016: Annals of Surgery
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
The concept of complete mesocolic excision and central vascular ligation for colonic cancer has been recently introduced. The paper describes a technique of right-sided complete mesocolic excision and intracorporeal anastomosis by using a single-port robotic approach with an additional conventional robotic port. We performed a single-port plus an additional port robotic surgery using the Da Vinci Single-Site platform via the Pfannenstiel incision and the wristed robotic instruments via an additional robotic port in the left lower quadrant...
October 2016: Annals of Surgical Treatment and Research
Anna C S Tan, Kunal K Dansingani, Lawrence A Yannuzzi, David Sarraf, K Bailey Freund
PURPOSE: To study the cross-sectional and en face optical coherence tomography angiography (OCTA) findings in Type 3 neovascularization (NV). METHODS: Optical coherence tomography angiography imaging of 27 eyes of 23 patients with Type 3 NV was analyzed with 9 eyes having consecutive follow-up OCTA studies. RESULTS: Type 3 NV appeared as a linear high-flow structure on cross-sectional OCTA corresponding to a high-flow tuft of vessels seen on en face OCTA...
October 5, 2016: Retina
Xiao Liu, Libing Wang, Zhenze Wang, Zhengxing Li, Hongyan Kang, Yubo Fan, Anqiang Sun, Xiaoyan Deng
Helical flow has been introduced to improve the hemodynamic performance of vascular devices such as arterial grafts, stents and arteriovenous shunts to overcome the flow induced thrombus formation and intimal hyperplasia. However, the quite low intensity of helical flow in the existing devices may limit their function. To obtain desirably high intensity, inspired by the helical flow and tapered configuration of the arterial system, we proposed a new conceptual design of the medical devices, which take the form of a tapered helical shape...
September 23, 2016: Journal of Biomechanics
Baoqiang Song, Jianwu Chen, Xianjie Ma, Yang Li, Juan Zhang, Shuzhong Guo
BACKGROUND: The anterior chest is an excellent donor site for cervicofacial reconstruction. Studies of chest flaps began as early as 1988 at our institution. We identified a new branch of the supraclavicular artery that nourishes the anterior chest, and on the basis of this finding, we created a new flap called the subclavicular flap. Unlike the supraclavicular flap, which is pedicled by the deltoid branch, this flap is primarily pedicled by the thoracic branch, and it shares similar vascular territory with the deltopectoral flap...
September 23, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Masaaki Murakami, Genichi Sakaguchi, Noriko Mori
OBJECTIVE: In patients with a high risk of fistula immaturity, we created arteriovenous fistulas (AVFs) combined with brachial artery superficialization. With this procedure, the superficialized arteries are used as drawing routes and the AVFs as returning routes. This is a technical report about AVFs combined with brachial artery superficialization. METHODS: Twenty-four consecutive patients with a high risk of fistula immaturity who underwent AVFs with brachial artery superficialization were included in this single-center retrospective study...
October 12, 2016: Journal of Vascular Surgery
Yeongu Chung, Sung Ho Lee, Seok Keun Choi
BACKGROUND: Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass is associated with several surgical problems. Despite the vascular patency and hemodynamic changes after the anastomosis, wound problems can be a major surgical complication. METHODS: In a review of 41 surgical cases of STA-MCA bypass for moyamoya disease or cerebral occlusive vascular diseases, we compared the conventional ("Out-to-In") dissection method for STA (n=23) with the "In-to-Out" (ITO) dissection method (n=18) and evaluated the surgical results with respect to wound problems...
October 11, 2016: World Neurosurgery
M Szabo-Pap, G Zadori, R Fedor, L Illesy, F Toth, Z Kanyari, D A Kovacs, B Nemes
Surgical complications (SCs) are still high potential causes of graft loss. The incidence has a huge amount of variations depending on many factors. Our aim was to study the postoperative technical complications following kidney transplantations (KTs) during a 5-year period between 2011 and 2015. In the observed time frame there were 47 SCs occurring in 32 (19.4%) patients of 165 KTs. Every complication was classified into 3 groups: vascular (11; 6.6%), urologic (16; 9.7%), and any others (20; 12.1%). The most common postoperative SCs in our center were hemorrhage (14; 8...
September 2016: Transplantation Proceedings
J C Araújo, R W D S Barbosa, M F Machado, P S Furtado, C M D Pugas, J S D A Filho, C F Lopes, R J C Mattoso, C L Neves
BACKGROUND: Renal transplantation is the treatment of choice for patients with stage V chronic kidney disease, which does not have contraindications to the procedure and is more cost-effective than dialysis treatments and provides better survival and quality of life. OBJECTIVE: The objective of this study was to evaluate the incidence of postoperative complications in kidney transplant recipients in a reference hospital. METHODOLOGY: This was a descriptive and retrospective study involving the analysis of patient records during hospitalization and outpatient treatment...
September 2016: Transplantation Proceedings
Emilio Trignano, Nefer Fallico, Gino Zingone, Luca Andrea Dessy, Gian Vittorio Campus
Background Microsurgery is very challenging, requiring a high degree of dexterity and manual skills that should be fully trained outside of the operating room. Common microsurgery courses usually follow a stepwise training approach beginning practice on nonliving models and proceeding with live rats. However, training on live rats raises certain issues, including ethical concerns as well as the associated costs. As such, there is an increasing drive toward alternative models. The current article describes a three-step training approach (latex glove-endovascular prosthesis-human placenta), which aims to prepare trainees for the clinical direct application...
October 12, 2016: Journal of Reconstructive Microsurgery
Mara C Modest, Eric J Moore, Kathryn M Van Abel, Jeffrey R Janus, John R Sims, Daniel L Price, Kerry D Olsen
OBJECTIVES/HYPOTHESIS: Discuss current techniques utilizing the scapular tip and subscapular system for free tissue reconstruction of maxillary defects and highlight the impact of medical modeling on these techniques with a case series. STUDY DESIGN: Case review series at an academic hospital of patients undergoing maxillectomy + thoracodorsal scapula composite free flap (TSCF) reconstruction. Three-dimensional (3D) models were used in the last five cases. METHODS: 3D modeling, surgical, functional, and aesthetic outcomes were reviewed...
October 12, 2016: Laryngoscope
Beata Pucher, Jaroslaw Szydlowski, Wieslaw Smoczyk, Katarzyna Jonczyk-Potoczna, Michal Grzegorowski, Aleksandra Korytowska
Tonsillectomy and adenoidectomy are the most common surgical procedures in pediatric otolaryngology. The incidence of primary hemorrhage after tonsillectomy in children ranges from 0.38 to 6%. The prevalence of secondary bleeding occurs in 0.5%-9.3% cases [1]. Authors present a case of an 11-year-old girl who experienced 6 delayed, massive post-tonsillectomy bleedings as a result of presence of vascular malformation and the activation of collateral circulation as a result of the left ECA ligature.
November 2016: International Journal of Pediatric Otorhinolaryngology
Pirjo Spuul, Thomas Daubon, Bettina Pitter, Florian Alonso, Isabelle Fremaux, IJsbrand Kramer, Eloi Montanez, Elisabeth Génot
During angiogenic sprouting, endothelial tip cells emerge from existing vessels in a process that requires vascular basement membrane degradation. Here, we show that F-actin/cortactin/P-Src-based matrix-degrading microdomains called podosomes contribute to this step. In vitro, VEGF-A/Notch signaling regulates the formation of functional podosomes in endothelial cells. Using a retinal neovascularization model, we demonstrate that tip cells assemble podosomes during physiological angiogenesis in vivo. In the retina, podosomes are also part of an interconnected network that surrounds large microvessels and impinges on the underlying basement membrane...
October 4, 2016: Cell Reports
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