A Simplified Lead Oxide Cadaver Injection Technique

Rees, M.; Taylor, G. Ian

doi:10.1097/00006534-198601000-00023

Cited by 211 publications

(98 citation statements)

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“…This blue solution had low density and proved to be quite effective in depicting even very small vessels. This technique is a modification of the technique described by other authors in previous studies 16 . Before the beginning of the dissection, there was an interval of 10 minutes for solidification of the dye solution.…”

Section: Methodsmentioning

confidence: 99%

Anatomic study of the dorsal arterial system of the hand

et al. 2004

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Historically, the dorsal arterial system of the hand received less attention than the palmar system. The studies concerning dorsal arterial anatomy present some controversies regarding the origin and presence of the dorsal metacarpal artery branches. Knowledge of the anatomy of dorsal metacarpal arteries is especially applied in the surgical planning for flaps taken from the dorsum of the hand. The purpose of this study is to analyze the arterial anatomy of the dorsum of the hand, compare our observations with those of previous studies from the literature, and therefore to define parameters for surgical planning for flaps supplied by the dorsal metacarpal arteries.METHOD: Twenty-six dissections were performed at the dorsum of the right hand of 26 cadavers by making a distalbased U-shaped incision. After catheterization of the radial artery at the wrist level, a plastic dye solution with low viscosity and quick solidification was injected to allow adequate exposure of even small vessels. The radial artery and its branches, the dorsal arterial arch, the dorsal metacarpal arteries, the distal and proximal communicating branches of the palmar system, and the distal cutaneous branches were carefully dissected and identified. RESULTS:The distal cutaneous branches originating from the dorsal metacarpal arteries were observed in all cases; these were located an average of 1.2 cm proximal from the metacarpophalangeal joint. The first dorsal metacarpal artery presented in 3 different patterns regarding its course: fascial, subfascial, and mixed. The branching pattern of the radial artery at the first intermetacarpal space was its division into 3 branches. We observed the presence of the dorsal arterial arch arising from the radial artery in 100% of the cases. The distance between the dorsal arterial arch and the branching point of the radial artery was an average of 2 cm. The first and second dorsal metacarpal arteries were visualized in all cases. The third and fourth dorsal metacarpal arteries were visualized in 96.2% and 92.3% of cases, respectively. There was proximal and distal communication between the dorsal arterial arch and the palmar system through the communicating branches contributing to the dorsal metacarpal artery formation.CONCLUSION: At the dorsum of the hand there is a rich arterial net that anastomoses with the palmar arterial system. This anatomical characteristic allows the utilization of the dorsal aspect of the hand as potential donor site for cutaneous flaps.

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Section: Methodsmentioning

confidence: 99%

Anatomic study of the dorsal arterial system of the hand

et al. 2004

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“…Since then, the technology has been widely used and improved as the gold standard for vascular visualization. [1][2][3][4][5] Recently, the development of digitalized techniques and diagnostic imaging techniques in the field of microsurgery has made it possible to apply three-dimensional (3D) reconstruction to observe the stereoscopic anatomy of the flap. [6] The flap blood supply can be visualized stereoscopically preoperatively, thus allowing the best design of the flap, the best surgical approach and the most suitable therapy protocol.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional digitalized virtual planning for saphenous artery flap: a pilot study

Zhang

Wen

Zhang

et al. 2016

Computer Assisted Surgery

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Objective: Since the 1970s, research and applications on flap and muscle flap had solved many problems in microsurgical reconstruction. However, the traditional flap design is completely dependent on two-dimensional (2D) images. The purpose of this study was to discuss the methods in the visualization of saphenous artery flap by digitalized technique and its applications by digitalized technique. Methods: Two adult fresh cadaver specimens, one male and one female, were subject to radiographic computerized tomography (CT) scanning before and after perfused with lead oxide-gelatine mixture, whose collimation are 0.625 mm (120 kV, 110 mA, 512 Â 512 matrix). Through Amira 5.4.1 software, the 2D images in DICOM format were transformed into the 3D models of the entire region. The structures of saphenous artery were observed and the digitized visible models of saphenous artery flap were established through three-dimensional (3D) computerized reconstructions methods from these data using Amira 5.4.1 software. Next six cases of soft-tissue defects of the tibia region, involving the exposure bones underwent contrast-enhanced CT angiography of lower limbs utilizing a 64-row multi-slice spiral CT after median cubital vein injection with Ultravist (3.5 ml/s). 2D images from these data in DICOM format were transformed into computer. The structures of saphenous artery flap were observed and measured using Amira 5.4.1 software. Then, all cases were treated by saphenous artery flap. Results: The 3D reconstructed visible models established from these datasets perfectly displayed the saphenous artery flap anatomy. In six cases, the main trunk and branched of the blood vessels in the designed flap were consistent with the surgical findings. The starting point of the saphenous artery to the average distance of the knee clearance were 119.2 ± 9.6 mm, the average diameter of the saphenous artery from the starting point were 1.5 ± 0.3 mm. The range of flap was 8.0 Â 5.0 cm to 20.0 Â 8.0 cm. All flaps survived well. After 8-24 months' follow-up the knee flexion was 120-140 , the straight 0-10 . There was no case appeared incision infection. Conclusions: The preoperative use of 3D digitalized virtual planning for the saphenous artery flap improves the surgical accuracy, decreases the operation time and increases the survival rate of the flap.

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“…Sharp dissection of the thoracodorsal vessel at the latissimus dorsi hilum level was performed. Lead oxide solution [10] was perfused under constant pressure (130 mm Hg) to highlight the fine intramuselular vascular distribution. Angiographic films were reviewed by surgeons and radiological experts.…”

Section: Methodsmentioning

confidence: 99%

Anatomical rationale for use of the latissimus dorsi flap during the cardiomyoplasty operation

et al. 1992

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Summary.The cardiomyoplasty procedure involves the use of a transformed skeletal muscle to augment cardiac pump function or to substitute for the heart after parietal resection. This study of the intramuscular vascularization of latissimus dorsi was carried out in order to establish the relationship between the dominant thoracodorsal blood supply and the distal supply issued from the intercostal and lumbar arteries. This data is mandatory for the safe manipulation of the muscle flap during cardiomyoplasty. Thirty human latissimus dorsi flaps were carefully studied. We confirmed anatomically as well as angiographically previous macroscopic anatomical reports, as well as the constancy of the neurovascular pedicle. Three principal branching patterns were observed for the thoracodorsal artery. The thoracodorsal artery divides into three main tributaries in 20/30 (67%), and into two tributaries in 10/30 (33%) of the flaps observed. When three tributaries were observed, one of them was a small recurrent artery for the proximal third of the latissimus dorsi (14/20, 70%). Thus the distal vascularization is actually dependant on three principals in 6/30 (20%) and two principals in 24/30 (80%). From these two or three principals emerge several subsequent longitudinal branches (5 to 9) that have a straight course until their distal anastomoses with segmental arterial pedicles issued from intercostal and lumbar arteries. The latter ligation can thus occur without ischemic damage to the medial and distal aspect of the flap. This study emphasizes that, due to macroscopic anatomic features and systematic intramuscular vascular distribution, the latissimus dorsi is probably the most suitable muscle for the purpose of cardiomyoplasty.Résumé. Le concept de cardiomyoplastie s'articule sur l'utilisation d'un muscle squelettique transformé, pour augmenter la fonction de pompe dévolue au myocarde, ou pour se substituer à celui-ci après une résection pariétale. La présente étude anatomique, étudiant la distribution vasculaire intramusculaire du m. grand dorsal, a été réalisée pour apprécier la distribution intramusculaire fine, ainsi que les relations existant entre l'apport thoraco-dorsal proximal prédominant et les deux sources d'apport vasculaire périphérique issues des artères intercostales et lombaires. Cette information est indispensable pour permettre une manipulation rigoureuse du muscle lors de la cardiomyoplastie. Trente muscles grands dorsaux ont été soigneusement étudiés. Nous avons confirmé les données macroscopiques déjà publiées, ainsi que la constance du pédicule thoraco-dorsal. Trois modes principaux de division au niveau du hile ont été reconnus. L'artère thoraco-dorsale se divise en trois branches principales dans 20/30 (67%) des cas, et en deux branches principales dans 10/30 (33%) des cas. Quand trois branches sont observées, l'une d'entre elles est une petite branche récurrente pour la portion proximale du muscle dans 14/20 (70%) des cas. En conséquence, la vascularisation distale est en réalité dépendante de tro...

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A Simplified Lead Oxide Cadaver Injection Technique

Cited by 211 publications

References 0 publications

Anatomic study of the dorsal arterial system of the hand

Anatomic study of the dorsal arterial system of the hand

Three-dimensional digitalized virtual planning for saphenous artery flap: a pilot study

Anatomical rationale for use of the latissimus dorsi flap during the cardiomyoplasty operation

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