Document Detail


Arterialized venous perfusion of composite tissue.
MedLine Citation:
PMID:  4025697     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The results of our experiment prove that arterialized venous perfusion is a viable means of nourishing complex composite tissue without using the arterial tree. Previous laboratory findings, coupled with the results of this experiment, demonstrate that as long as proximal arterial inflow is ensured, both the arterial and venous trees need not be intact to keep tissue alive. Rather, it seems that the prerequisites for tissue survival are that at least one of the two systems be intact and that there be sufficient inflow and outflow channels available. Whether these channels are arteries or veins is probably not important. The use of properly placed efferent or afferent arteriovenous fistulas allows one system to provide both physiologic functions. Whether the efferent arterial anastomosis stays open over the long term appears to be inconsequential. Survival is ensured by either direct perfusion with oxygen delivery through the venous tree or through the eventual ingrowth of recipient vessels into the flap by way of the delay phenomena. This perfusion technique is ideally suited for tissue with an inadequate arterial tree but with an intact venous system devoid of venous valves (most veins less than 1.5 mm in diameter). A well-vascularized recipient bed capable of providing vessel ingrowth into transferred tissue may be important in the case of delayed arteriovenous fistula occlusion secondary to intimal hyperplasia; therefore, further experimental study of these flaps must be undertaken before arterialized venous flaps can be recommended for placement in recipient sites compromised due to radiation, ischemia, diabetes, or other causes of small vessel disease in the recipient bed. Although efferent arteriovenous fistulas are currently used to provide arterialized venous perfusion in selected cases of end stage arterial occlusive and vasospastic disease, perhaps their greatest role is in the management of tissue transfer with an inadequate arterial tree. Much knowledge must be gained to understand the physiologic principles and requirements for optimal perfusion. Many questions are left unanswered. For example, in those arteriovenous fistulas that narrow or occlude secondary to neointimal hyperplasia or other causes, which channels (veins or arteries?) are used for perfusion during recipient vessel growth? Can intimal hyperplasia be reversed or prevented by drug therapy and would this be advantageous? Can venous valves be made incompetent so that this technique can be used for larger vessels?(ABSTRACT TRUNCATED AT 400 WORDS)
Authors:
L S Nichter; P C Haines
Related Documents :
18639097 - Diagnosis of cerebral arteriovenous malformations with three-dimensional ct angiography.
3189997 - Combined treatment of arteriovenous malformations by transarterial microembolization an...
18161677 - Effect of upper arm brachial basilic and prosthetic forearm arteriovenous fistula on le...
7156927 - Pulmonary arteriovenous fistula.
758987 - The relationship of mitral valve prolapse to obstructive coronary artery disease. a hem...
17525047 - Training models for coronary surgery.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  150     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1985 Aug 
Date Detail:
Created Date:  1985-09-11     Completed Date:  1985-09-11     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  191-6     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Arteries / surgery*
Arteriovenous Shunt, Surgical / methods
Ear / blood supply*
Male
Microsurgery
Perfusion
Rabbits
Vascular Surgical Procedures / methods
Veins / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Studies on the transmission of Venezuelan equine encephalitis virus by Colombian simuliidae (Diptera...
Next Document:  Endothelialization of human collagen surfaces with human adult endothelial cells.