Microvascular Reconstruction after Intra‐arterial Chemotherapy with Concomitant Radiation

Valentino, Joseph; Helton, W. Brian; Unnikrishnan, Raman; Kudrimoti, Mahesh; Arnold, Susanne M.; Gal, Thomas J.

doi:10.1177/0194599813497923

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…Changes including intimal thickening, proteoglycan deposition, and inflammatory cell infiltrate that are consistent with early stages of atherosclerosis were observed in the tissue samples obtained from recipient arteries within a few years after irradiation. In another study, arterial thrombosis and flap failure complications were reported at rates of 50% and 25%, respectively, in microvascular reconstructions after chemoradiation therapy (21).…”

Section: Discussionmentioning

confidence: 92%

Zor Durumlarda Alici Damar Olarak Serbest Flep Ki̇meri̇zasyonunu İçeren Farkli Modali̇telerle Bi̇rli̇kte Torakoakromi̇al Arteryel Gövde Ve Sefali̇k Ven Si̇stemi̇ni̇n Kullanimi

Altuntaş

Yavuz

Aydın

2021

SDÜ Tıp Fakültesi Dergisi

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Baş-boyun, kol ve gövdeye konforlu ve güvenilir olarak serbest flep transferi için, bu bölgelerin ana alıcı damarlarının önceki cerrahi, radyoterapi veya travma sonucu elverişsiz olmaları durumunda, cerrahlara Torakoakromial arter gövdesi ve Sefalik venin (TAT-CV) varlığını hatırlatmayı amaçladık. Gereç ve YöntemBaş-boyun veya üst ekstremitede tümör veya travmayı içeren, bu vasküler sistemin farklı modalitelerle kullanılarak serbest doku transferi ile tedavi edilen 8 hasta retrospektif olarak incelendi. BulgularBu vasküler sistem bütün vakalarda güvenilir olduğunu kanıtladı. Pektoral flep ile kimerizasyonu mümkün kıldı. Baş-boyun rekonstrüksiyonu için 6 hastada ve 2 üst ekstremite restorasyonunda kullanıldı. Anastomozların TAT-CV bölgesine taşınması ve CV transpo-zisyonu, dolaşım sorunu olan flebi kurtarmak için oldukça hızlı ve güvenilir yöntemler olarak bulundu. SonuçBirçok rekonstrüktif cerrah tarafından anatomik olarak iyi bilinmesine rağmen, diseksiyonunun kolaylığı, tutarlılığı, farklı çaplı dallarının sağladığı kanlanma ve stratejik lokasyonu yeterince rağbet görmemektedir. Ayrıca pektoralis majör flep transferi sırasında ek doku gereksinimi olduğunda, bu vasküler sistem alıcı olarak orada hazır bulunmaktadır.

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Section: Discussionmentioning

confidence: 92%

Zor Durumlarda Alici Damar Olarak Serbest Flep Ki̇meri̇zasyonunu İçeren Farkli Modali̇telerle Bi̇rli̇kte Torakoakromi̇al Arteryel Gövde Ve Sefali̇k Ven Si̇stemi̇ni̇n Kullanimi

Altuntaş

Yavuz

Aydın

2021

SDÜ Tıp Fakültesi Dergisi

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“…External beam radiation has been shown to cause changes to the tunica intima of arteries. 26,27 However, although some small case series showed increased arterial related complications, 28 others larger series have not. 11,27 Even with extensive prior treatment and neck procedures, we found in our series of patients that the facial artery, lingual artery, and superior thyroid artery often remain viable donor options.…”

Section: Discussionmentioning

confidence: 99%

Dual‐phase CT angiography for presurgical planning in patients with vessel‐depleted neck

Patel

Huang

et al. 2019

Head & Neck

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Background Microvascular reconstruction in vessel‐depleted necks is challenging due to limited availability of recipient vessels. We examine the utility of dual‐phase CT angiography (CTA), which delineates both arteries and veins, for preoperative planning in such difficult cases. Methods Retrospective chart review of a single surgeon from July 2013 to July 2017 in a tertiary referral center was performed. Patient characteristics, operative details, and surgical outcomes were examined. Results Thirteen patients met inclusion criteria. The operative plan was changed to a local flap for one patient as a result of imaging; free tissue transfer was performed for the remaining cases with 100% flap survival rate. Average operative time and ischemia time were 524 ± 110 minutes and 153 ± 47 minutes, respectively. Conclusions Dual‐phase CTA can evaluate potential venous and arterial recipient vessel and guide surgical explorations. As such, it may aid in presurgical planning for microvascular free tissue transfer in vessel‐depleted necks.

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“…In this way a perfect like-with-like tissue restoration is reached, leading to a good and stable result. For example, this procedure can be particularly useful after radiotherapy or high-energy traumas, which critically impair the quality of the vessels and lead to a much higher rate of complication (Valentino et al, 2013).…”

Section: Casementioning

confidence: 99%

Versatility of perforator flaps for lower extremity defect coverage: Technical highlights and single center experience with 87 consecutive cases

et al. 2022

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Background Lower extremity defects have been and remain one of the greatest challenges in reconstructive surgery. Perforator flaps have been accepted as a valid procedure to cover such a defect. Different techniques have been described and nowadays many options are available. However, there were not studies that comprehensively review the most modern techniques and clinical application of the use of perforator flaps in the lower extremity reconstruction. In the present report, we gathered most of them, presenting an updated and large case series where different pedicled and free perforators flaps were employed in simple and complex scenarios in a large series of cases. Patients and Methods Eighty‐seven patients presenting soft tissue defects of the lower extremities were treated by means of different perforator‐based flaps, in either free or pedicled fashion. The flaps were based on different perforator vessels, namely deep lateral circumflex femoral artery, profunda femoris artery, superficial femoral artery, medial sural artery, peroneal artery, posterior tibial artery, anterior tibial artery, and medial plantar artery. Patients' mean age was 61.9 years old (range 21—87 years old), 58 were males and 29 females. The 12 patients received sequential flaps and 9 received double free flaps, for a total sum of 106 flaps. The causes of the defects were trauma in 41 patients and tumors in 46 patients, located throughout the lower limbs. Size of the defect ranged from 3 cm × 4 cm to 25 cm × 9 cm. Results The dimensions of the flap skin paddles ranged from 3 cm × 4 cm to 16 cm × 5 cm for the pedicled flaps (42 cases) and from 6 cm × 4 cm to 25 cm × 8 cm for the free ones (45 cases). Mean flap's size was 48 cm2 (range 12–80 cm2) for the pedicle flaps and 104 cm2 (range 24—200 cm2) for free flaps. In two pedicled cases, a distal congestion was encountered, requiring a second surgery. Debulking procedures were performed in 2 patients. All the patients were successfully treated and no flaps were lost. Mean follow‐up period was 8.4 months (range 3–12 months). No range of motion impairment was encountered after surgery and all the patients were able to return to habitual life. Conclusions The present case series highlights the reliability and versatility of perforator flaps for lower extremity defect coverage. Following careful consideration of the etiology, dimensions, location, patient comorbidities, and presence of adequate perforators, a pedicled or free perforator flap can be potentially successful in the most disparate circumstances.

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Microvascular Reconstruction after Intra‐arterial Chemotherapy with Concomitant Radiation

Cited by 5 publications

References 17 publications

Zor Durumlarda Alici Damar Olarak Serbest Flep Ki̇meri̇zasyonunu İçeren Farkli Modali̇telerle Bi̇rli̇kte Torakoakromi̇al Arteryel Gövde Ve Sefali̇k Ven Si̇stemi̇ni̇n Kullanimi

Zor Durumlarda Alici Damar Olarak Serbest Flep Ki̇meri̇zasyonunu İçeren Farkli Modali̇telerle Bi̇rli̇kte Torakoakromi̇al Arteryel Gövde Ve Sefali̇k Ven Si̇stemi̇ni̇n Kullanimi

Dual‐phase CT angiography for presurgical planning in patients with vessel‐depleted neck

Versatility of perforator flaps for lower extremity defect coverage: Technical highlights and single center experience with 87 consecutive cases

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