The Experts below are selected from a list of 129 Experts worldwide ranked by ideXlab platform
Nayak Satheesha - One of the best experts on this subject based on the ideXlab platform.
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jugulo facial venous circle accessory slip of trapezius and absence of typical facial vein clinically important anatomical variations
Journal of The Anatomical Society of India, 2017Co-Authors: Nayak SatheeshaAbstract:Abstract Knowledge of facial and external jugular vein variations is useful for medical disciplines such as radiology, anesthesia, general surgery and plastic surgery for the success in their procedures in the head and neck region. I report a unique combination of venous and muscular variation in the left side of the neck of an adult male cadaver. The typical facial vein was absent. Facial vein was represented as a Vena comitans of facial artery. The common facial vein joined with the external jugular vein to form a jugulo-facial venous circle above the lateral part of the clavicle. This circle was closely related to an accessory muscle slip from the trapezius. Further, the common facial vein was connected to the anterior jugular vein through a large anonymous vein. I discuss the clinical implications of these variations.
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Jugulo-facial venous circle, accessory slip of trapezius and absence of typical facial vein—Clinically important anatomical variations
Journal of The Anatomical Society of India, 2017Co-Authors: Nayak SatheeshaAbstract:Abstract Knowledge of facial and external jugular vein variations is useful for medical disciplines such as radiology, anesthesia, general surgery and plastic surgery for the success in their procedures in the head and neck region. I report a unique combination of venous and muscular variation in the left side of the neck of an adult male cadaver. The typical facial vein was absent. Facial vein was represented as a Vena comitans of facial artery. The common facial vein joined with the external jugular vein to form a jugulo-facial venous circle above the lateral part of the clavicle. This circle was closely related to an accessory muscle slip from the trapezius. Further, the common facial vein was connected to the anterior jugular vein through a large anonymous vein. I discuss the clinical implications of these variations.
Alexander Gaggl - One of the best experts on this subject based on the ideXlab platform.
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Arterialized Venous Bone Flaps: An Experimental Investigation
Scientific Reports, 2016Co-Authors: Farzad Borumandi, James P. Higgins, Heinz Buerger, Anna Vasilyeva, Memmet Emre Benlidayi, Leman Sencar, Alexander GagglAbstract:In arterialized venous flaps (AVFs) the venous network is used to revascularize the flap. While the feasibility of AVFs in soft tissues has been reported there is no study on osseous AVFs. In this study we aim to assess the flap survival of osseous AVFs in a pig model. Medial femoral condyle flaps were elevated in 18 pigs. Three groups were created: AVF (n = 6), conventional arterial flap (cAF, n = 6) and bone graft (BG, n = 6). The AVFs were created by anastomosis of genicular artery with one Vena comitans while leaving one efferent vein for drainage. After 6 months the specimens were harvested. The histology and histomorphometry of of the bone in cAF and AVF was significantly superior to bone grafts with a higher bone volume in AVFs (p = 0.01). This study demonstrates that osseous free flaps may be supported and survive using the technique of arterialization of the venous network. The concept of AVFs in osseous flaps may be feasible for revascularization of free flaps with an inadequate artery but well developed veins. Further experimental and clinical studies are needed to assess the feasibility of clinical use of arterialized venous bone flaps.
Geoffrey G. Hallock - One of the best experts on this subject based on the ideXlab platform.
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Venae comitantes as a source of vein grafts.
Journal of Reconstructive Microsurgery, 2007Co-Authors: Geoffrey G. HallockAbstract:The use of vein grafts is commonplace and often essential in microvascular surgery. Typically, these are obtained from the superficial venous system, and most commonly from the lower extremity using branches or segments of the greater or lesser saphenous veins. Unfortunately, on rare occasions these usual donor sites may have been totally exploited. This potential dilemma can be solved by using the deep Venae comitantes as autogenous vein grafts. By way of example, these can be Venae comitantes of the free flap itself, or via salvage of parts using a Vena comitans that accompanied a major limb source vessel.
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The anatomy of the extended peroneal venous system.
Plastic & Reconstructive Surgery, 1999Co-Authors: Geoffrey G. HallockAbstract:The fibula has deservedly become a workhorse flap for vascularized bone grafts. As with most flaps, much is known regarding idiosyncrasies of its arterial supply, and the corresponding venous system has generally been assumed to be comparable. Because this donor site has become increasingly versatile, a detailed anatomic study that would verify this latter assertion should be important. Therefore, venous mapping specifically of the peroneal Venae comitantes was completed in 29 fresh lower limbs. In every specimen, paired Venae comitantes of large caliber indeed paralleled the course of the peroneal artery. All were of quality satisfactory for microanastomoses, which should provide reassurance that preoperative evaluation of the peroneal venous system is not routinely indicated. However, anatomic variations proved to be the norm. The two Venae comitantes did not necessarily coalesce into a single common peroneal vein [6 of 29 (21 percent)]. Usually, the lateral peroneal vein was the larger and continued proximally either alone (17 percent) or as the common peroneal vein (66 percent) to form the lateral tibioperoneal Vena comitans. Thus, the venous pedicle of a fibula flap could be lengthened up to its confluence with the popliteal vein, a maneuver that potentially could obviate the need for a vein graft at least on the venous side. Although anomalies of the peroneal artery could preclude use of the fibula altogether, there appeared to be no such contraindications from a venous standpoint, despite the fact that the venous anatomy was unique in every individual. Some important similarities in patterns, though, do exist. For example, a common peroneal vein was formed by the juncture of the lateral peroneal vein and some combination of branches joining the lateral posterior tibial vein and medial peroneal vein in 63 percent of all limbs. Because exceptions are the rule, the choice of donor vein and venous pedicle length best remains an intraoperative decision dependent on the presenting anatomy.
Farzad Borumandi - One of the best experts on this subject based on the ideXlab platform.
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Arterialized Venous Bone Flaps: An Experimental Investigation
Scientific Reports, 2016Co-Authors: Farzad Borumandi, James P. Higgins, Heinz Buerger, Anna Vasilyeva, Memmet Emre Benlidayi, Leman Sencar, Alexander GagglAbstract:In arterialized venous flaps (AVFs) the venous network is used to revascularize the flap. While the feasibility of AVFs in soft tissues has been reported there is no study on osseous AVFs. In this study we aim to assess the flap survival of osseous AVFs in a pig model. Medial femoral condyle flaps were elevated in 18 pigs. Three groups were created: AVF (n = 6), conventional arterial flap (cAF, n = 6) and bone graft (BG, n = 6). The AVFs were created by anastomosis of genicular artery with one Vena comitans while leaving one efferent vein for drainage. After 6 months the specimens were harvested. The histology and histomorphometry of of the bone in cAF and AVF was significantly superior to bone grafts with a higher bone volume in AVFs (p = 0.01). This study demonstrates that osseous free flaps may be supported and survive using the technique of arterialization of the venous network. The concept of AVFs in osseous flaps may be feasible for revascularization of free flaps with an inadequate artery but well developed veins. Further experimental and clinical studies are needed to assess the feasibility of clinical use of arterialized venous bone flaps.
Makoto Omori - One of the best experts on this subject based on the ideXlab platform.
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Short-term postoperative flow changes after free radial forearm flap transfer: possible cause of vascular occlusion.
Annals of Plastic Surgery, 2003Co-Authors: Akihiro Ichinose, Shinya Tahara, Hiroto Terashi, Tadashi Nomura, Makoto OmoriAbstract:The risk for free flap thrombosis is greatly influenced by blood flow. Postoperative hemodynamic changes in vascular pedicles of the microvascular skin flap have not been reported, however. This study focuses on the intraoperative and postoperative changes in the flow volume in the vascular pedicles of the free forearm flap examined by color Doppler ultrasonography. The arterial flow volume increased continuously until day 7, compared with which, the volume after flap elevation was 36%. On day 1, it reached only 52%. In the venous pedicle, the flow volume through the cutaneous vein was only 37% compared with that through the radial Vena comitans after flap elevation, whereas the volume through both veins was equal on day 7. Drastic changes in the flow explain the possible vascular occlusion during the early postoperative period in the free forearm flap transfer.
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Fail-safe drainage procedure in free radial forearm flap transfer.
Journal of Reconstructive Microsurgery, 2003Co-Authors: Akihiro Ichinose, Shinya Tahara, Makoto Omori, Satoshi Yokoo, Suguru Miyamura, Yori Tsuji, Kenich Nibu, Miki SaitoAbstract:The reliability of the free radial forearm flap is widely accepted; however, postoperative venous thrombosis still occurs occasionally. Thus, establishment of a fail-safe drainage system has been a challenging frontier. A total of 405 consecutive free radial forearm flap transfers, carried out in the authors' department between 1987 to 2002, were reviewed retrospectively. The most reliable drainage method comprised the dual flap drainage veins of the superficial venous system (the cutaneous vein) and the deep system (the radial Vena comitans), including their connecting cubital perforating vein, and the two neck recipient veins of the internal jugular and the external jugular venous systems. None of the flaps transferred by this method incurred venous failure, regardless of the surgeons conducting the operation. This study on the venous network in drainage systems of the free radial forearm flap demonstrated that the described method functions in a self-sustaining manner, and contributes to protection against venous catastrophe.