title: Increased patency of artificial microvascular grafts using arteriovenous fistula loops: a two-stage procedure for lengthening the pedicle of free-tissue transfer.
abstract: The effect of a high-flow system on the patency of artificial microvascular grafts (AMG) was investigated using arteriovenous (A-V) fistula loops made of polytetrafluoroethylene (PTFE) in a clinically useful longer length. At a second stage, the A-V loops, matured for 7 days, were used as recipient conduits for free-tissue transfer. The patency rates of 5-cm long PTFE A-V fistula loops were compared with 5-cm and 1-cm long interpositional micrografts in a rat model. The patency rate of the loops at 7 days was 80 percent, compared to 0 percent for both the 5-cm and 1-cm interpositional grafts. A-V fistula loops matured for 7 days in vivo were divided in their midsections and used as arterial and venous conduits (each 2.5 cm long) for free epigastric flaps (3 x 6 cm) raised from the contralateral groin. Sixty-seven percent (8/12) of the free flaps were viable at 7 days. The A-V fistula loop in a high-flow system has a beneficial effect in maintaining patency of AMGs. PTFE fistula loops matured for 7 days can be used as arterial and venous conduits for microsurgical tissue transfer in rats.
authors.affiliation: Department of Surgery, Mount Sinai Medical Center, New York, New York, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Choi
authors.forename: M B
authors.initials: MB
authors.lastname: Hirigoyen
authors.forename: W X
authors.initials: WX
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Weinberg
authors.forename: L
authors.initials: L
authors.lastname: Silver
authors.forename: J K
authors.initials: JK
authors.lastname: Chun
mesh_terms: D000818:Animals; D001807:Blood Vessel Prosthesis; D005260:Female; D008833:Microcirculation / Q000601:surgery*; D011138:Polytetrafluoroethylene; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps / Q000098:blood supply / Q000379:methods*; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods
chemical_list: D011138:Polytetrafluoroethylene