Objective To present a method for quantifying the anastomosis between two vessels based on angiograpy and provide a theoretical basis for vascular study in skin flap. Methods Ten bilateral skin flaps of 20 cm×20 cmbased on deep iliac circumflex vessels were elevated fromthe abdominal wall including musculus rectus abdominis and deep superior epigastric vessels in 5 minipigs which were 100-115 cm in length and 25-35 kg in weight. One side was inserted an expander under the panniculus carnosus and was expanded regularly with 30-40 ml isotonic Na chloride injection (expanded group) and the other was unexpanded group which were without any treatment. A X-ray image of the flap vessles was obtained after a gelatinlead oxide mixture was carotid arterially injected and 24 hours of cryopreservation of the body. Three parallel lines with equal interval perpendicular to long axis of the two vessels were designed at the communication area. Vessel anastomosis quantifying was determined by counting the number of marks derived from the intersections of the lines and the vessels and statistical analysis was carried out. Results The mark of intersectionin expanded group (81.20±10.33) was more than that in unexpanded group (22.40±5.41), showing significant difference(Plt;0.01). Conclusion The method for quantifying vessel anastomosis in skin flap is simple, reliable, and easytoperform. The principles of this procedure may also be applied to other experimental and clinical studies.
OBJECTIVE: To study the anatomical basis for reconstruction of vertebral artery with neighboring non-trunk arteries. METHODS: Twenty preserved adult cadavers were used in this study to observe the morphology of superior thyroid artery, inferior thyroid artery, transverse cervical artery, thyrocervical trunk and extracerebral portion of vertebral artery, and reconstruction of vertebral artery with these arteries was simulated in two preserved cadavers. RESULTS: The calibers of superior or inferior thyroid artery, or transverse cervical artery were more than 2 mm in diameter, and the arteries had suitable free length for end-to-side anastomosis with vertebral artery. Thyrocervical artery had similar caliber to vertebral artery so that end-to-end anastomosis could be carried out between them, but only 38.5% of this artery had adequate artery trunk (more than 10 mm). It was proved from the simulated procedures that the reconstruction of vertebral artery with these neighboring non-trunk arteries was possible. CONCLUSION: Reconstruction of vertebral artery with neighboring non-trunk arteries has anatomical basis and can be used clinically for treatment of the lesion affecting the first or second portion of vertebral artery.
ObjectiveTo investigate the advantages of magnetic compressive anastomosis (MCA) for non-suture femoral artery anastomosis. MethodsTwelve adult health mongrel dogs,weighing (16.5±3.6) kg,were selected for in situ end-to-end anastomosis of the femoral artery.One side of the femoral artery was anastomosised with MCA (group A) and the other side of the femoral artery was anastomosised by hand-suturing (group B).The anastomosis time,complications,and vascular bursting pressure were recorded.Gross observation,histological staining (HE and Masson),and scanning electron microscopy observation were performed at 2,4,12,and 24 weeks postoperatively. ResultsThe anastomosis time in group A [(3.89±1.16) minutes] was significantly shorter than that in group B [(14.16±3.72) minutes] (t=14.226,P=0.000).The complication rate of group A (0) was significantly lower than that of group B (75%)(P=0.000).At immediate,4 and 12 weeks after operation,the vascular bursting pressure of anastomosis site in group A was more than 280 mm Hg (1 mm Hg=0.133 kPa),and was (140.11±15.23),(180.31±24.55),and more than 280 mm Hg in group B,showing significant differences at immediate and 4 weeks (P<0.05),but no significant difference at 12 weeks (P>0.05).In group A at 4 weeks,good intima contact,smooth endothelium,and regular arrangement of endothelial cells were observed;at 12 weeks,chronic inflammation was present,with a few lymphocytes infiltration;and at 24 weeks,inflammation significantly decreased.But in group B,obvious suture foreign body and scar formation were observed,which led to uneven surface with lumen incomplete intima,and irregular endothelial cells in arrangement disorder. ConclusionCompared with traditional hand-suturing,the MCA has the advantages of shorter operation time,higher patency rate,less complication,and better healing at the anastomotic site.Non-suture anastomosis of the femoral artery by MCA can achieve reliable results.