Intravascular stenting (IVaS) method for fingertip replantation.
Remarkable progress has been made in microsurgery. However, fingertip replantation following amputation has not gained much popularity because of its technical difficulty. We have developed the intravascular stenting (IVaS) method, in which a nylon monofilament is placed inside the vessel lumen to act as a temporary stent, facilitating anastomosis completion. This report describes 7 fingertip replantations using the IVaS method. Intravascular stent size varied from 4-0 to 6-0 (0.199-0.07 mm diameter). There were no cases in which the back wall of a vessel became inadvertently caught in the anastomosis. The overall survival rate for distal digital replants was 85% (6/7 replants). It is very difficult to evenly anastomose vessels of differing diameter, especially on a supermicrosurgical scale. In this respect, the IVaS method plays a role in stably anchoring the 2 vessel ends, allowing for the even spacing of suture knots, even in vessels of different caliber. Because of its ease of use and exactitude, many surgeons may be able to use the IVaS method to reliably complete small anastomoses in fingertip replantations.
Narushima
Mitsunaga
M
Department of Plastic and Reconstructive Surgery, Tokyo University School of Medicine, Tokyo, Japan.
Mihara
Makoto
M
Koshima
Isao
I
Gonda
Koichi
K
Takuya
Iida
I
Kato
Harunosuke
H
Nakanishi
Kenji
K
Yamamoto
Yusuke
Y
Araki
Jun
J
Abe
Hiroaki
H
Mundinger
Gerhard S
GS
Kikuchi
Kazuki
K
Uehara
Eri
E
D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000601:surgery*; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012092:Replantation / Q000379:methods*; D015607:Stents; D014656:Vascular Surgical Procedures / Q000379:methods