Background: An arteriotomy on a branch of the middle cerebral artery (MCA) is required in the procedure of the direct anastomosis for the treatment of moyamoya disease, and the artery comes to be collapsed after blood is washed out. The phenomenon makes the microsurgical procedure difficult during direct anastomosis.
Methods: A piece of 3-0 blue monofilament polypropylene suture (PROLENE*, ETHICON Inc., a Johnson & Johnson Company, Somerville, New Jersey) was inserted into the lumen of the recipient artery though the ostium after termination of arteriotomy. The diameter of 3-0 PROLENE* was between 0.20 and 0.249 mm. PROLENE*, a length that was more than the length of the arteriotomy and was less than the distance between the 2 occlusion clamps placed on the recipient artery. At this time, the lumen was reopened and the wall of the recipient artery was easily passed by a microneedle with 11-0 monofilament without injury to the posterior wall of the recipient artery by the microneedle. Confirmation as to whether the microneedle snagged and injured the posterior wall of the recipient artery or not was unnecessary with this method.
Results: Anastomosis was easily performed using this technique for the treatment of moyamoya disease.
Conclusions: Clinical application of the present technique makes the anastomotic procedure easy, even when the diameter of the recipient artery is as small as 0.5 mm.
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http://dx.doi.org/10.1016/j.surneu.2003.11.007 | DOI Listing |
Acta Obstet Gynecol Scand
January 2025
Department of Gynecology, Rennes University Hospital, Hôpital Sud, Rennes, France.
Introduction: Graft optimization is a necessity in order to develop uterus transplantation from brain-dead donors, as a complement to living donors, as these grafts are rare and the last organs retrieved in multiple organ donation. The aim of this study was to assess the feasibility and interest of hypothermic machine perfusion (HMP) in uterus transplantation using a porcine model; secondary outcomes were the evaluation of the graft's tolerance to a prolonged cold ischaemia time and to find new biomarkers of uterus viability.
Material And Methods: Fifteen uterus allotransplantations were performed in a porcine model, after 18 h of cold ischaemia, divided in three groups: Static cold storage in a HTK solution, HMP (with the VitaSmart (™) machine Bridge to Life Ltd.
Pediatr Nephrol
January 2025
CERTAIN Research Network, Heidelberg, Germany.
Background: We investigated factors associated with post-transplant growth in pediatric kidney transplant (KTx) recipients with a focus on plasma bicarbonate (HCO3) and estimated the effect of alkali treatment on growth.
Methods: In this study of the CERTAIN Registry, data were collected up to 5 years post-transplant. Generalized Additive Mixed Models were applied to assess the association between post-transplant growth and covariates.
Clin Pract
December 2024
Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Hepatopulmonary syndrome (HPS), defined by the presence of pulmonary vascular dilatations that cause right-to-left transpulmonary shunting of venous blood with a consequential increase in the alveolar-arterial oxygen gradient, is a relatively frequent complication of chronic liver disease. While orthotopic liver transplantation (OLT) is indicated and often curative in HPS patients with end-stage liver disease (ESLD), little is known about the peri- and post-operative-period risks of CVA in OLT recipients with HPS. : We report a case series of five non-consecutive OLT recipients with HPS who developed ischemic and/or hemorrhagic CVAs during or shortly after OLT, raising concern that the risks of neurological complications remain increased even after OLT.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
January 2025
Shonan Kamakura General Hospital, Kamakura, Japan.
Introduction: Blunt brachial artery injuries (BAI) require reconstruction with an extensive vein graft due to the wide area of arterial damage. In the upper arm, safe options for pedicle flaps are limited, and selecting recipient vessels for free-flap surgery is challenging, complicating the treatment of soft tissue injuries associated with blunt BAI. This study aimed to analyze the characteristics and soft tissue reconstruction of blunt BAI and propose treatment strategies for treating associated soft tissue injuries.
View Article and Find Full Text PDFFront Pediatr
January 2025
Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Objective: To discover the potential association between diminished intraoperative average SctO levels and postoperative neurodevelopmental delays among patients after pediatric living-donor liver transplantation.
Study Design: Patients undergoing living-donor liver transplantation were recruited for this trial. The neurodevelopment status of patients was assessed using the Ages Stages Questionnaires.
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