Effects of Flow Patterns and Hemodynamic Force on Vascular Endothelium in the Temporary Arteriovenous Shunt Loop in Rabbits

Tanaka, Yoshio; Koghure, Tetsukuni; Ueno, Masaki; Sugiyama, Hitoshi; Hamamoto, Yhusuke; Tamai, Motoki; Taguchi, Noriyuki; Sakamoto, Haruhiko

doi:10.1055/s-0033-1343500

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…First, the arteriovenous loop was established in a large animal model with a large vessel diameter, simplifying the microsurgical difficulty. Second, it has been documented that the loop thrombosis rate is also related to loop length, the radius of curvature, and blood flow 24. We inset a sufficiently long IVG into the arteriovenous loop to provide a tension-free anastomosis, hence reducing thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…Second, it has been documented that the loop thrombosis rate is also related to loop length, the radius of curvature, and blood flow. 24 We inset a sufficiently long IVG into the arteriovenous loop to provide a tension-free anastomosis, hence reducing thrombosis. Finally, compared with other experiments, no silicon plate was placed beneath the arteriovenous loop, potentially reducing vascular damage caused by the mechanical force of a foreign body.…”

Section: Discussionmentioning

confidence: 99%

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Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Wang

et al. 2023

Journal of Craniofacial Surgery

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Background: Arteriovenous loops have a high potency to induce angiogenesis and are promising to solve the problem of scarce implanted pedicle sources and insufficient neovascularization in flap prefabrication. But there is a lack of large animal experiments to support their clinical application. Therefore, we aimed to explore the feasibility of prefabricating large flaps based on arteriovenous loops in pigs. Methods: Five minipigs were used. In the experimental group, a 10-cm-long ear vein graft was microanastomosed with the saphenous artery and vein to form an arteriovenous loop and implanted under the medial thigh flap. A month later, a 10×10 cm prefabricated flap pedicled with the arteriovenous loop was elevated and sutured in situ. In the control group, a 10×10 cm flap with no vascular pedicle was elevated completely and sutured in situ in the same position. The patency of the arteriovenous loop was evaluated by angiography 30 days after implantation, and the viability of flaps was assessed by macroscopic analysis 10 days after elevation. Three animals received arteriovenous loop flaps unilaterally and no-pedicle flaps unilaterally. Two animals received arteriovenous loop flaps bilaterally. Results: In the experimental group, no thrombi were exhibited in any arteriovenous loop. All 7 prefabricated flaps survived uneventfully. In the control group, 3 flaps were completely necrotic. Conclusion: The arteriovenous loops with long interpositional venous grafts can be used as vascular pedicles to prefabricated large area and well-vascularized flaps. This approach can greatly expand the application of flap prefabrication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Wang

et al. 2023

Journal of Craniofacial Surgery

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“…unter Verwendung von Hilfsmitteln (Gehstützen, Rollator) an [1]. [22,23,24]; auch der umgekehrte Weg ist bei ischämischen Defekten beschrieben (sog. Konzept des "Nutrient Flap", erstmals beschrieben durch Mimoun et al [25]).…”

Section: Verwendete Lappenunclassified

Revaskularisation vor Defektdeckung – essenzielle Schnittstelle zwischen plastischer Chirurgie und Gefäßchirurgie

Meyer,

Rother,

Thamm

2023

Zentralbl Chir

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ZusammenfassungKomplexe, ischämische Wunden im Bereich der unteren Extremität mit freiliegenden tiefen Strukturen stellen große Herausforderungen an die behandelnden Fachdisziplinen dar. Als Alternative zur Majoramputation ergibt sich für ausgewählte Patienten die Möglichkeit eines kombinierten Verfahrens mittels arterieller Rekonstruktion und nachfolgender mikrochirurgischer Defektdeckung durch eine freie Lappentransplantation. Als arterielle Rekonstruktionsverfahren stehen endovaskuläre oder offen chirurgische Verfahren wie Bypassrekonstruktion oder Implantation eines arteriovenösen Loops als Vorbereitung für die Defektdeckung zur Verfügung. Ziel der arteriellen Rekonstruktion ist die Schaffung einer ausreichenden Perfusion zur Defektdeckung an der Extremität sowie die Schaffung von Anschlussgefäßen für die Lappentransplantation. Die Auswahl des Lappens richtet sich u. a. nach der Größe und Ausdehnung des Defektes sowie nach dem Vorhandensein einer Osteomyelitis. Dies kann ein- oder zweizeitig erfolgen. In Zentren ist dieses kombinierte Vorgehen als sichere Methode etabliert. Die Mikroperfusionsanalyse des Gewebes mittels Indocyaningrün erhöht nochmals die Sicherheit des Verfahrens und kann Perfusionsdefizite aufzeigen. Das kombinierte Verfahren mittels arterieller Rekonstruktion und freiem Gewebetransfer liefert gute Langzeitergebnisse im Hinblick auf amputationsfreies Überleben und postoperative Mobilität. Wichtig für die Indikationsstellung ist eine korrekte Patientenselektion unter Berücksichtigung der Kontraindikationen. Dieses Verfahren sollte für alle mobilen Patienten mit komplexen Weichteildefekten vor einer Majoramputation evaluiert werden.

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Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up

Rother

Müller‐Mohnssen

Lang

et al. 2019

International Wound Journal

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Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long-term performance, flap autonomy, and the flap perfusion. Patients receiving this combined reconstruction at a single-centre institution were included. During follow-up examination, the patency of arterial reconstruction was investigated by duplex ultrasound. Flap micro-circulation was assessed by laser Doppler flowmetry and white light tissue spectrometry (O2C) as well as by indocyanine green fluorescence angiography. Twentythree patients could be clinically followed up. Duplex ultrasound showed, in four cases, arterial pedicle occlusion in spite of vital flap. Comparison of the O2C perfusion parameters between flaps with occluded pedicles and those with intact inflow showed no significant difference (parameters sO2: P = .82; Flow: P = .31). Similar results were obtained by fluorescence angiography; no significant difference could be detected between both groups (parameters Ingress P = .13; Ingressrate P = .54). Combined vascular reconstruction with free tissue transfer is associated with a good long-term outcome and wound closure. Even after flap transplantation to areas with critical tissue perfusion, the flap can develop autonomy and thus survive after pedicle occlusion.

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Effects of Flow Patterns and Hemodynamic Force on Vascular Endothelium in the Temporary Arteriovenous Shunt Loop in Rabbits

Cited by 3 publications

References 25 publications

Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop

Revaskularisation vor Defektdeckung – essenzielle Schnittstelle zwischen plastischer Chirurgie und Gefäßchirurgie

Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up

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