A modified “interrupted” method with resting of the suture needle on the vessel wall for microvascular anastomosis

Microsurgery ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 89-90
Author(s):  
Hui‐Kuang Huang ◽  
Jung‐Pan Wang ◽  
Yuan‐Kun Tu
Keyword(s):  
Vessel Wall ◽  
Microvascular Anastomosis

An Objective Evaluation of an Injured Vessel Wall Using Fluorescein Sodium before Microvascular Anastomosis in an Experimental Rat Model

2011 ◽  
Vol 27 (05) ◽  
pp. 321-326
Author(s):  
Muhammet Uraloğlu ◽  
Hakan Orbay ◽  
Murat Livaoğlu ◽  
Nihal Aydın ◽  
Nurşen Saraç ◽  
...  
Keyword(s):  
Rat Model ◽  
Vessel Wall ◽  
Objective Evaluation ◽  
Fluorescein Sodium ◽  
Microvascular Anastomosis ◽  
Experimental Rat Model

Micro – Arterial Anastomosis Using Only Two Sutures and an Autogenous Cuff

1988 ◽  
Vol 13 (1) ◽  
pp. 44-49
Author(s):  
R. R. KANAUJIA
Keyword(s):  
Blood Flow ◽  
Patency Rate ◽  
Vessel Wall ◽  
Conventional Technique ◽  
Albino Rats ◽  
Microvascular Anastomosis ◽  
Arterial Anastomosis ◽  
Wistar Albino Rats ◽  
Good Patency ◽  
Epigastric Arteries

Microvascular anastomosis using only two sutures and an autogenous cuff was carried out in an experimental model of Wistar albino rats. 40 femoral and 40 epigastric arteries were used for this cuff technique and compared with conventional technique in the same number of vessels. The cuff technique is simple, quick, causes less trauma to the vessel wall and gives a good patency rate. Anastomosis of an artery 0.5mm in diameter is very easy with the cuff technique (98% patency) which remains difficult using conventional technique (0% patency). The disadvantage of this technique may be leakage of blood just after releasing the clamps due to restoration of blood flow, but this is easily controlled within few minutes by mild compression.

The Double Stitch Everting Technique in the End-to-Side Microvascular Anastomosis: Validation of the Technique Using a Randomized N-of-1 Trial

2020 ◽  
Author(s):  
George C. Dindelegan ◽  
Ruben Dammers ◽  
Alex V. Oradan ◽  
Ramona C. Vinasi ◽  
Maximilian Dindelegan ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Randomized Trial ◽  
Analysis Of Variance ◽  
Femoral Artery ◽  
Vessel Wall ◽  
Microvascular Anastomosis ◽  
Classic Technique ◽  
The Mean ◽  
Confounder Adjustment ◽  
Different Levels

Abstract Background The double stitch everting (DSE) technique, in which time is won by leaving the needle inside the vessel wall in-between stitching, is a modification of the end-to-side (ETS) anastomosis in the interest of reducing anastomosis time. This ensures proper wall eversion, intima-to-intima contact, and improved suture symmetry. Materials and Methods We designed an N-of-1 randomized trial with each microsurgeon as their own control. We included 10 microsurgeons of different levels of experience who were then asked to perform classic and DSE ETS anastomoses on the chicken leg and rat femoral models. Every anastomosis was cut and evaluated using blinded assessment. Two-way analysis of variance (ANOVA) and multivariable logistic regression were used to analyze the results and for confounder adjustment. Results A total of 210 anastomoses were performed, of which 177 on the chicken leg and 43 on the rat femoral artery and vein. From the 210 anastomoses, 111 were performed using the classic technique and 99 using the DSE technique. The mean anastomosis time was 28.8 ± 11.3 minutes in the classic group and 24.6 ± 12 minutes in the DSE group (p < 0.001, t-test). There was a significant reduction (p < 0.001, two-way ANOVA) in the number of mistakes when using the DSE technique (mean 5.5 ± 2.6) compared with those using the classic technique (mean 7.7 ± 3.4). Conclusion The DSE technique for ETS anastomoses improves anastomoses times in experienced and moderately experienced microsurgeons while also improving or maintaining suture symmetry and lowering the number of mistakes.

The molecular mechanism of mechanotransduction in vascular homeostasis and disease

2020 ◽  
Vol 134 (17) ◽  
pp. 2399-2418
Author(s):  
Yoshito Yamashiro ◽  
Hiromi Yanagisawa
Keyword(s):  
Shear Stress ◽  
Blood Vessels ◽  
Vessel Wall ◽  
Vascular Diseases ◽  
Cell Interactions ◽  
Aortic Aneurysms ◽  
Cyclic Stretch ◽  
Mechanical Stimuli ◽  
Vascular Homeostasis ◽  
Matrix Cell

Abstract Blood vessels are constantly exposed to mechanical stimuli such as shear stress due to flow and pulsatile stretch. The extracellular matrix maintains the structural integrity of the vessel wall and coordinates with a dynamic mechanical environment to provide cues to initiate intracellular signaling pathway(s), thereby changing cellular behaviors and functions. However, the precise role of matrix–cell interactions involved in mechanotransduction during vascular homeostasis and disease development remains to be fully determined. In this review, we introduce hemodynamics forces in blood vessels and the initial sensors of mechanical stimuli, including cell–cell junctional molecules, G-protein-coupled receptors (GPCRs), multiple ion channels, and a variety of small GTPases. We then highlight the molecular mechanotransduction events in the vessel wall triggered by laminar shear stress (LSS) and disturbed shear stress (DSS) on vascular endothelial cells (ECs), and cyclic stretch in ECs and vascular smooth muscle cells (SMCs)—both of which activate several key transcription factors. Finally, we provide a recent overview of matrix–cell interactions and mechanotransduction centered on fibronectin in ECs and thrombospondin-1 in SMCs. The results of this review suggest that abnormal mechanical cues or altered responses to mechanical stimuli in EC and SMCs serve as the molecular basis of vascular diseases such as atherosclerosis, hypertension and aortic aneurysms. Collecting evidence and advancing knowledge on the mechanotransduction in the vessel wall can lead to a new direction of therapeutic interventions for vascular diseases.

Oxidative Stress and Atherosclerosis: Its Relationship to Growth Factors, Thrombus Formation and Therapeutic Approaches

1999 ◽  
Vol 82 (S 01) ◽  
pp. 32-37 ◽  
Author(s):  
Karlheinz Peter ◽  
Wolfgang Kübler ◽  
Johannes Ruef ◽  
Thomas K. Nordt ◽  
Marschall S. Runge ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Growth Factors ◽  
Vessel Wall ◽  
Inflammatory Responses ◽  
Plaque Rupture ◽  
Thrombus Formation ◽  
Vascular Lesion ◽  
Coagulation System ◽  
Therapeutic Approaches ◽  
Causative Relationship

SummaryThe initiating event of atherogenesis is thought to be an injury to the vessel wall resulting in endothelial dysfunction. This is followed by key features of atherosclerotic plaque formation such as inflammatory responses, cell proliferation and remodeling of the vasculature, finally leading to vascular lesion formation, plaque rupture, thrombosis and tissue infarction. A causative relationship exists between these events and oxidative stress in the vessel wall. Besides leukocytes, vascular cells are a potent source of oxygen-derived free radicals. Oxidants exert mitogenic effects that are partially mediated through generation of growth factors. Mitogens, on the other hand, are potent stimulators of oxidant generation, indicating a putative self-perpetuating mechanism of atherogenesis. Oxidants influence the balance of the coagulation system towards platelet aggregation and thrombus formation. Therapeutic approaches by means of antioxidants are promising in both experimental and clinical designs. However, additional clinical trials are necessary to assess the role of antioxidants in cardiovascular disease.

Gene Induction in Vessel Wall Injury

1993 ◽  
Vol 70 (01) ◽  
pp. 180-183 ◽  
Author(s):  
Mark B Taubman
Keyword(s):  
Vessel Wall ◽  
Gene Induction ◽  
Wall Injury
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