Predicting Thrombosis Formation in 1-mm-Diameter Arterial Anastomoses with Transit-Time Ultrasound Technology

Shaughness, Gabrielle; Blackburn, Collin; Ballestín, Alberto; Akelina, Yelena; Ascherman, Jeffrey A.

doi:10.1097/prs.0000000000003350

Cited by 19 publications

(16 citation statements)

References 17 publications

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“…The selected time for primary ischemia was 8 hours, based on previous studies and our own research experience with this animal model. 2,11,[14][15][16] Macroscopically, our study results showed a significant decrease in flap survival in the I/R control group compared with the control group (p < 0.05). These results conflicted with the histological findings as higher levels of edema formation (p < 0.05), neutrophil infiltration (p < 0.05), and structural damage were observed in the I/R group than in the control group.…”

Section: Discussionmentioning

confidence: 52%

Effects of Ischemic Preconditioning and C1 Esterase Inhibitor Administration following Ischemia-Reperfusion Injury in a Rat Skin Flap Model

Masa

Casado-Pérez

Crespo-Lora

et al. 2020

J Reconstr Microsurg

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Background Ischemia-reperfusion (I/R) injury is a serious condition that can affect the success rate of microsurgical reconstructions of ischemic amputated limbs and complex tissue defects requiring free tissue transfers. The purpose of this study was to evaluate the effects of ischemic preconditioning (IPC) and C1 esterase inhibitor (C1-Inh) intravenous administration following I/R injury in a rat skin flap model. Methods Superficial caudal epigastric skin flaps (3 cm × 7 cm) were performed on 50 Wistar rats that were randomly divided into five groups. Ischemia was not induced in the control group. All other flaps underwent 8 hours of ischemia prior to revascularization: I/R control group (8-hour ischemia), IPC group (preconditioning protocol + 8-hour ischemia), C1-Inh group (8-hour ischemia + C1-Inh), and IPC + C1-Inh group (preconditioning protocol + 8-hour ischemia + C1-Inh). Survival areas were macroscopically assessed after 1 week of surgery, and histopathological and biochemical evaluations were also measured. Results There were no significant differences in flap survival between the treatment groups that were suffering 8 hours of ischemia and the control group. A significant increase in neovascularization and lower edema formation were observed in the IPC group compared with that in the I/R group. Biochemical parameters did not show any significant differences. Conclusion Intravenous administration of C1-Inh did not significantly modulate I/R-related damage in this experimental model, but further research is needed. On the other hand, IPC reduces tissue damage and improves neovascularization, confirming its potential protective effects in skin flaps following I/R injury.

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Section: Discussionmentioning

confidence: 52%

Effects of Ischemic Preconditioning and C1 Esterase Inhibitor Administration following Ischemia-Reperfusion Injury in a Rat Skin Flap Model

Masa

Casado-Pérez

Crespo-Lora

et al. 2020

J Reconstr Microsurg

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“…During the surgical procedures, we have measured the blood flow using transit-time ultrasound technology, which is a novel and objective method of evaluation of microsurgical anastomoses [53,54]. Blood flow measurement is of crucial importance in microsurgery [55], as part of the tissue damage due to ischemia is responsible for slowing down blood flow and causing thrombosis [56].…”

Section: Discussionmentioning

confidence: 99%

Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study

et al. 2018

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Ischemia reperfusion injury is associated with tissue damage and inflammation, and is one of the main factors causing flap failure in reconstructive microsurgery. Although ischemia-reperfusion (I/R) injury is a well-studied aspect of flap survival, its biological mechanisms remain to be elucidated. To better understand the biological processes of ischemia reperfusion injury, and to develop further therapeutic strategies, the main objective of this study was to identify the gene expression pattern and histological changes in an I/R injury animal model. Fourteen rats (n = 7/group) were randomly divided into control or ischemia-reperfusion group (8 hours of ischemia). Microsurgical anastomoses were objectively assessed using transit-time-ultrasound technology. Seven days after surgery, flap survival was evaluated and tissue samples were harvested for anatomopathological and gene-expression analyses.The I/R injury reduced the survival of free flaps and histological analyses revealed a subcutaneous edema together with an inflammatory infiltrate. Interestingly, the Arginase 1 expression level as well as the ratio of Arginase 1/Nitric oxide synthase 2 showed a significant increase in the I/R group. In summary, here we describe a well-characterized I/R animal model that may serve to evaluate therapeutic agents under reproducible and controlled conditions. Moreover, this model could be especially useful for the evaluation of arginase inhibitors and different compounds of potential interest in reconstructive microsurgery.

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“…21 A transit-time ultrasound probe (Transonic Aure-Flo) was used as a secondary form of vessel patency assessment. 13 Patency was confirmed in all vessels prior to closing the surgical site and completing the procedure.…”

Section: Empty-and-refill Testmentioning

confidence: 99%

Histological Changes in the Rat Femoral Artery Following the Use of the Empty-and-Refill Test

Naides

Noland

et al. 2018

J reconstr Microsurg

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Predicting Thrombosis Formation in 1-mm-Diameter Arterial Anastomoses with Transit-Time Ultrasound Technology

Cited by 19 publications

References 17 publications

Effects of Ischemic Preconditioning and C1 Esterase Inhibitor Administration following Ischemia-Reperfusion Injury in a Rat Skin Flap Model

Effects of Ischemic Preconditioning and C1 Esterase Inhibitor Administration following Ischemia-Reperfusion Injury in a Rat Skin Flap Model

Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study

Histological Changes in the Rat Femoral Artery Following the Use of the Empty-and-Refill Test

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