End-to-side (ETS) microsurgical anastomosis is a powerful technique in microsurgery. It can overcome vessel's diameter discrepancy and preserve the distal blood flow. Optimal angle of the ETS anastomosis has been debated and studied, and is currently limited to animal models. Computational model using Finite Element Analysis (FEA) was used to simulate the models with 45 (model), 90 (model), and 135 (model) ETS anastomosis angles. Flow dynamics including flow velocity and wall shear rate were studied and compared. Maximum flow velocity ranged from the highest to the lowest in model, model, and model, respectively. The velocity in model135 showed fluctuation flow. The maximum wall shear rate and distribution were highest in model and lowest in model. ETS anastomosis angle of 90 degrees provided the most favourable flow dynamics to prevent shear related thrombosis in comparison to ETS anastomosis at 45 and 135 degrees.
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http://dx.doi.org/10.1038/s41598-024-77390-x | DOI Listing |
Ann Vasc Surg
December 2024
Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Angiology and Vascular Surgery, Centro Hospitalar de Trás os Montes e Alto Douro, Vila Real, Portugal.
Autogenous arteriovenous fistula (AVF) is the vascular access of choice for chronic kidney disease to patients requiring hemodialysis. However, there still needs to be more consensus on whether the best surgical approach is an end-of-vein to side-of-artery (ETS) or a side-of-vein to side-of-artery (STS) anastomosis. This study aims to compare venous maturation rates, mid-term patency and post-operative steal syndrome rates between ETS and STS techniques for arteriovenous fistulas.
View Article and Find Full Text PDFAnn Plast Surg
December 2024
From the Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Background: Complex lower extremity defects are difficult to cover and often require multiple free tissue transfers. Chimeric anterolateral thigh free flaps (ALTF) and peroneal artery perforator free flaps (PAPF) have been designed specifically as an alternative for reconstruction with arterial end-to-side (ETS) anastomosis. We aimed to assess our institutional experience with this technique and to define its role in complex lower extremity reconstruction.
View Article and Find Full Text PDFSci Rep
October 2024
Department of Plastic and Reconstructive Surgery, Corewell Health East William Beaumont University Hospital, Royal Oak, MI, USA.
End-to-side (ETS) microsurgical anastomosis is a powerful technique in microsurgery. It can overcome vessel's diameter discrepancy and preserve the distal blood flow. Optimal angle of the ETS anastomosis has been debated and studied, and is currently limited to animal models.
View Article and Find Full Text PDFBraz J Cardiovasc Surg
September 2024
Department of Thoracic and Cardiovascular Surgery, Cardiac Surgery Service, Edgardo Rebagliati Martins National Hospital, Lima, Peru.
Introduction: The operating room is no longer the ideal place for early surgica training of cardiothoracic surgery residents, forcing the search for simulation-based learning options. The study's aim was the construction and surgicaltraining of coronary anastomosis in a portable, low-cost, homemade simulator.
Methods: This is an observational, analytical, and multicenter study.
J Hand Microsurg
October 2024
Welsh Centre for Burns & Plastic Surgery, Morriston Hospital, Swansea, UK.
Background: Free flap reconstruction of the lower extremity is technically challenging and may suffer from higher complication rates than other anatomical sites. One important vascular consideration in the reconstructive process is the microsurgical anastomotic technique, namely whether an end-to-end (ETE) or end-to side (ETS) technique is used. The ETS technique is often preferred by lower limb microsurgeons, who describe its benefits of improved distal perfusion.
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