scholarly journals Extended latissimus dorsi chimeric thoracoplasty with a vascular supercharge for Aspergillus empyema

2019 ◽  
Vol 30 (3) ◽  
pp. 491-492
Author(s):  
Masanori Shimomura ◽  
Yoshihiro Sowa ◽  
Ryo Yamochi ◽  
Masayoshi Inoue
Keyword(s):  
Blood Flow ◽  
Indocyanine Green ◽  
Intravenous Injection ◽  
Blood Supply ◽  
Latissimus Dorsi ◽  
Serratus Anterior

Abstract The latissimus dorsi and serratus anterior muscles are available for reconstruction coverage of thoracic defects. We performed extended latissimus dorsi-serratus anterior chimeric thoraco-myoplasty with a vascular supercharge to maintain sufficient blood supply to the flaps because of a deficiency in the distal blood flow to the flap revealed by an intravenous injection of indocyanine green and simultaneous endobronchial embolization for refractory Aspergillus empyema.

Intraoperative fluorescent angiography with indocyanine green in surgery of peripheral nerve injuries

2021 ◽  
pp. 224-234
Author(s):  
Dmitry Vladimirovich Svistov ◽  
Dzhamaludin Magomedrasulovich Isaev ◽  
Alexey Ivanovich Gaivoronsky ◽  
Leonid Igorevich Churikov ◽  
Kirill Vladimirovich Belyakov
Keyword(s):  
Blood Flow ◽  
Peripheral Nerve ◽  
Indocyanine Green ◽  
Blood Supply ◽  
Nerve Trunk ◽  
Point Of View ◽  
Intraoperative Angiography ◽  
Surgical Interventions ◽  
The Moment ◽  
Nerve Surgery

Despite the widespread introduction of microsurgical techniques in peripheral nerve surgery, a relatively high percentage of unsatisfactory results remains. Often, when treating patients with traumatic neuropathies, the surgeon faces the problem of diastasis between the ends of the damaged nerve. As a rule, in the presence of diastasis greater than 5 cm, it is recommended to perform inter-bundle autoneuroplasty. However, overcoming diastasis less than 5 cm may be accompanied by tension of the nerve trunk, which leads to a violation of its blood supply. In this case, the outcome of the intervention may be unsatisfactory, despite the operation performed perfectly from a technical point of view. An important factor of the outcome of surgical treatment of neuropathies of various origins is the preservation of adequate blood supply to the nerve trunk in the intraoperative period. In order to assess the blood flow in the nerve trunk, the possibility of using intraoperative fluorescent angiography for reconstructive surgical interventions on nerves was considered. In patients with a complete anatomical break of the large nerve trunk, at the moment of overcoming diastasis, intraoperative angiography of the nerve trunk was performed by intravenous administration of indocyanine green, with simultaneous registration of the tension force with which the nerve trunk was affected. In addition, fluorescent angiography was performed after the restoration of the integrity of the nerve trunk, thus assessing the safety, adequacy and effectiveness of blood flow in it. It was found that intraoperative angiography is an accessible and easily implementable technique to determine the safety and, not least, the adequacy and effectiveness of the blood flow in the nerve trunk, to study the mechanisms of compensation of blood supply to the nerve after microsurgical epineural suture, and to assess the quality of matching the stumps of the nerve axis, preventing the possibility of «torsion».

scholarly journals Fluorescence imaging in evaluating the revascularization of heterotopically transplanted primate trachea segment

2020 ◽  
Vol 22 (2) ◽  
pp. 80-85
Author(s):  
A. L. Akopov ◽  
G. V. Papayan ◽  
S. D. Gorbunkov ◽  
S. V. Orlov ◽  
D. D. Karal-Ogly ◽  
...  
Keyword(s):  
Stem Cells ◽  
Blood Flow ◽  
Mesenchymal Stem Cells ◽  
Indocyanine Green ◽  
Latissimus Dorsi ◽  
Fluorescence Angiography ◽  
Lateral Part ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Indocyanine Green Fluorescence Angiography

Objective: to assess the potentials of using indocyanine green fluorescence angiography in evaluating revascularization of tissue-engineered construct that was obtained from the decellularized biological matrix of primate trachea, including using mesenchymal stem cells, after heterotopic tracheal allotransplantation. Material and methods. Tracheas were obtained from two male hamadryas baboons. After decellularization, 4 cm segments of tracheas were implanted under the lateral part of the latissimus dorsi in two healthy primates, one after recellularization with mesenchymal stem cells (animal 1), and the second without recellularization (animal 2). Immunosuppressive therapy was not performed. Blood flow in the transplanted segment of the trachea was evaluated 60 days after transplantation by surgical isolation of the flap of the latissimus dorsi with the transplanted segment of the trachea, while maintaining blood flow through the thoracodorsal artery. Indocyanine green near-infrared fluorescence angiography was visualized using a FLUM-808 multispectral fluorescence organoscope. Results. Sixty days after implantation, the tracheal cartilaginous framework macroscopically appeared to be intact in both animals, tightly integrated into the muscle tissue. The framework retained its natural color. After intravenous injection of indocyanine green, the tracheal vessels were visualized in both animals. Intercartilaginous vessels and portions of the cartilaginous semi-rings devoid of vessels were clearly distinguished. The entire implanted segment was almost uniformly vascularized. No local disruptions in blood supply were observed. The fluorescence brightness of the tracheal vessels was 193 ± 17 cu and 198 ± 10 cu in animals 1 and 2, respectively. The average muscle brightness in the implantation zone was 159 ± 9 cu and 116 ± 8 cu in animals 1 and 2, respectively. Conclusion. Indocyanine green fluorescence angiography is characterized by high-contrast images and high sensitivity. This facilitates vascular patency visualization and allows to assess the degree of neoangiogenesis after experimental transplantation of the tracheal segment, at different stages of experiment, without euthanizing the animal.

Innervation of endoneurial microvessels in human sural nerve

1992 ◽  
Vol 50 (1) ◽  
pp. 920-921
Author(s):  
John L. Beggs ◽  
Peter C. Johnson ◽  
Astrid G. Olafsen ◽  
C. Jane Watkins
Keyword(s):  
Blood Flow ◽  
Blood Vessels ◽  
Blood Supply ◽  
Peripheral Nerves ◽  
Sural Nerve ◽  
Nerve Fibers ◽  
Arterial Supply ◽  
Autonomic Nerve ◽  
Vasa Nervorum ◽  
Endoneurial Blood Flow

The blood supply (vasa nervorum) to peripheral nerves is composed of an interconnected dual circulation. The endoneurium of nerve fascicles is maintained by the intrinsic circulation which is composed of microvessels primarily of capillary caliber. Transperineurial arterioles link the intrinsic circulation with the extrinsic arterial supply located in the epineurium. Blood flow in the vasa nervorum is neurogenically influenced (1,2). Although a recent hypothesis proposes that endoneurial blood flow is controlled by the action of autonomic nerve fibers associated with epineurial arterioles (2), our recent studies (3) show that in addition to epineurial arterioles other segments of the vasa nervorum are also innervated. In this study, we examine blood vessels of the endoneurium for possible innervation.

Rapid Infusion of Hydroxyethyl Starch 70/0.5 but not Acetate Ringer’s Solution Decreases the Plasma Concentration of Propofol during Target-controlled Infusion

2016 ◽  
Vol 125 (2) ◽  
pp. 304-312 ◽  
Author(s):  
Sayako Itakura ◽  
Kenichi Masui ◽  
Tomiei Kazama
Keyword(s):  
Blood Flow ◽  
Plasma Concentration ◽  
Indocyanine Green ◽  
Blood Volume ◽  
Hydroxyethyl Starch ◽  
Hepatic Blood Flow ◽  
Disappearance Rate ◽  
Rapid Infusion ◽  
Ringer’S Solution ◽  
Target Controlled Infusion

Abstract Background Rapid fluid infusion resulting in increased hepatic blood flow may decrease the propofol plasma concentration (Cp) because propofol is a high hepatic extraction drug. The authors investigated the effects of rapid colloid and crystalloid infusions on the propofol Cp during target-controlled infusion. Methods Thirty-six patients were randomly assigned to 1 of 3 interventions (12 patients per group). At least 30 min after the start of propofol infusion, patients received either a 6% hydroxyethyl starch (HES) solution at 24 ml·kg−1·h−1 or acetated Ringer’s solution at 24 or 2 ml·kg−1·h−1 during the first 20 min. In all groups, acetated Ringer’s solution was infused at 2 ml·kg−1·h−1 during the next 20 min. The propofol Cp was measured every 2.5 min as the primary outcome. Cardiac output, blood volume, and indocyanine green disappearance rate were determined using a pulse dye densitogram analyzer before and after the start of fluid administration. Effective hepatic blood flow was calculated as the blood volume multiplied by the indocyanine green disappearance rate. Results The rapid HES infusion significantly decreased the propofol Cp by 22 to 37%, compared to the Cp at 0 min, whereas the rapid or maintenance infusion of acetate Ringer’s solution did not decrease the propofol Cp. Rapid HES infusion, but not acetate Ringer’s solution infusion, increased the effective hepatic blood flow. Conclusions Rapid HES infusion increased the effective hepatic blood flow, resulting in a decreased propofol Cp during target-controlled infusion. Rapid HES infusion should be used cautiously as it may decrease the depth of anesthesia.

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