Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis
Background:. Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2017-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001533 |
| _version_ | 1818689368177508352 |
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| author | Kensuke Tashiro, MD Shuji Yamashita, MD Mitsunaga Narushima, MD Isao Koshima, MD Shimpei Miyamoto, MD |
| author_facet | Kensuke Tashiro, MD Shuji Yamashita, MD Mitsunaga Narushima, MD Isao Koshima, MD Shimpei Miyamoto, MD |
| author_sort | Kensuke Tashiro, MD |
| collection | DOAJ |
| description | Background:. Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined its usefulness.
Methods:. Between January 2013 and February 2015, 11 anastomoses in 11 cases of lymphaticovenular anastomosis for lymphedema patients, 14 anastomoses in 7 cases of free perforator flap transfer with supermicrosurgical perforator-to-perforator anastomosis, and 9 anastomoses in 5 cases of fingertip replantation were performed using hemi-IVaS. Time required for anastomosis and complications were examined. Flap survival rate was also examined in free perforator flap transfer cases and fingertip replantation cases.
Results:. In all cases, anastomoses were performed without complications such as inadvertent catching of the back wall of the vessel during the procedure or the need for reanastomoses. The average time required to complete the anastomosis was 16.4 ± 3.20 minutes using the hemi IVaS technique. All flaps survived in the supermicrosurgical perforator-to-perforator anastomosis as well as fingertip replantation cases.
Conclusions:. Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery. |
| first_indexed | 2024-12-17T12:08:59Z |
| format | Article |
| id | doaj.art-d5093405c8284777b9e7103f301b0a06 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-17T12:08:59Z |
| publishDate | 2017-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-d5093405c8284777b9e7103f301b0a062022-12-21T21:49:30ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742017-11-01511e153310.1097/GOX.0000000000001533201711000-00010Hemi-Intravascular Stenting for Supermicrosurgical AnastomosisKensuke Tashiro, MD0Shuji Yamashita, MD1Mitsunaga Narushima, MD2Isao Koshima, MD3Shimpei Miyamoto, MD4From the *Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan; and †Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.From the *Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan; and †Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.From the *Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan; and †Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.From the *Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan; and †Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.From the *Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan; and †Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.Background:. Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined its usefulness. Methods:. Between January 2013 and February 2015, 11 anastomoses in 11 cases of lymphaticovenular anastomosis for lymphedema patients, 14 anastomoses in 7 cases of free perforator flap transfer with supermicrosurgical perforator-to-perforator anastomosis, and 9 anastomoses in 5 cases of fingertip replantation were performed using hemi-IVaS. Time required for anastomosis and complications were examined. Flap survival rate was also examined in free perforator flap transfer cases and fingertip replantation cases. Results:. In all cases, anastomoses were performed without complications such as inadvertent catching of the back wall of the vessel during the procedure or the need for reanastomoses. The average time required to complete the anastomosis was 16.4 ± 3.20 minutes using the hemi IVaS technique. All flaps survived in the supermicrosurgical perforator-to-perforator anastomosis as well as fingertip replantation cases. Conclusions:. Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001533 |
| spellingShingle | Kensuke Tashiro, MD Shuji Yamashita, MD Mitsunaga Narushima, MD Isao Koshima, MD Shimpei Miyamoto, MD Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis Plastic and Reconstructive Surgery, Global Open |
| title | Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis |
| title_full | Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis |
| title_fullStr | Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis |
| title_full_unstemmed | Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis |
| title_short | Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis |
| title_sort | hemi intravascular stenting for supermicrosurgical anastomosis |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001533 |
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