Background: Interposition microvascular grafting may be required to bridge arterial defects during digital replantation or revascularization and has traditionally been performed utilizing a venous autograft. Arterial interposition grafting has been shown to be superior in maintaining patency in large vessel surgery; there are case reports of its use in microsurgery.
Methods: Six fellowship-trained hand and microsurgeons performed arterial and venous interposition grafts on the femoral arteries of 40 Wistar rats. After sectioning one femoral artery a segment of the contralateral femoral artery or vein was obtained. The time was recorded per graft and patency tested 10 minutes following grafting by an independent assessor. Each surgeon also completed a questionnaire detailing regular microsurgical volume, technical ease, and conceptual preference for either graft.
Results: Time for arterial interposition (median time 51.7 minutes) was longer than venous grafting (median time 45.9 minutes, = 0.075). Arterial grafts were more likely to be patent or questionably patent (odds ratio [OR] = 6.77, = 0.031). All surgeons found arterial interposition grafting technically easier and preferred it conceptually. Improvements were noted in patency rates (OR = 11.29, = 0.018) and avoidance of anastomotic leak (OR = 0.19, = 0.029) when surgeons performed moderate levels or greater of microsurgery within their regular practice.
Conclusion: Greater immediate patency was noted with arterial interposition grafting in a rodent model when compared to venous grafting, although procedural time was greater. All surgeons found arterial grafting technically easier. Arterial microvascular grafting may be useful in the setting of digital replantation or revascularization with an arterial defect.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1055/s-0043-1776735 | DOI Listing |
Arch Peru Cardiol Cir Cardiovasc
December 2024
Surgical Center, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru. Surgical Center Hospital Nacional Edgardo Rebagliati Martins Lima Peru.
Multiple Aneurysmal Arterial Disease (MAD) is an extremely rare arterial vascular condition and is produced by an abnormal alteration of smooth muscle cells and neutrophils, producing a multiple-aneurysmal degeneration. We present the case of a 36-year-old patient with a MAD in the cerebral territory and extremities with no surgical indication; however, with an aneurysm of the right inferior renal segmental artery, inferior mesenteric artery, left common iliac artery, and right internal iliac artery with surgical indication. An open approach with single-stage surgical repair, including graft interposition, bypass, exclusion, and vascular reimplantation, was performed.
View Article and Find Full Text PDFOpen Heart
January 2025
Department of Cardiac Surgery, University Hospital Erlangen, Erlangen, Bayern, Germany
Background: Aortic coarctation (CoA) is a congenital anomaly leading to upper-body hypertension and lower-body hypotension. Despite surgical or interventional treatment, arterial hypertension may develop and contribute to morbidity and mortality. Conventional blood pressure (BP) measurement methods lack precision for individual diagnoses and therapeutic decisions.
View Article and Find Full Text PDFCureus
December 2024
Vascular Surgery, King Saud Medical City, Riyadh, SAU.
Aortoenteric fistula (AEF) is an abnormal connection between the aorta and the adjacent gastrointestinal (GI) tract and is often misdiagnosed in clinical practice. We present the case of a 65-year-old male, who presented with upper GI bleeding and melena. The patient underwent upper and lower GI examinations with no conclusive findings.
View Article and Find Full Text PDFJ Brachial Plex Peripher Nerve Inj
January 2025
Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany.
To date, there are no uniform guidelines for the treatment of obstetric plexus lesions in German-speaking countries. An end-to-end direct suture after resection of trunk neuroma is recommended for surgical treatment if tension-free coaptation is possible, whereas the use of autologous nerve grafts bridging the gap between the adaptation margins is advised by consensus if tension-free coaptation is impossible. The aim of the study was to investigate which reconstruction strategy may provide a better recovery of motor function for patients after obstetric brachial plexus lesion.
View Article and Find Full Text PDFAnn Chir Plast Esthet
January 2025
Service de chirurgie plastique et reconstructrice, HELORA Jolimont, rue Ferrer 159, 7100 La Louvière, Belgium.
Introduction: Esophagus reconstruction could be complicated by leakage, stenosis or graft loss. Salvage surgery may be needed in case of failure of endoscopic treatment or large esophagus defect. Although free jejunal flap is admitted for salvage head and neck reconstruction, few reports assess the results of free jejunal interposition in salvage esophagus reconstruction.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!