A New Method of Microvascular Anastomosis for Atherosclerotic Vessel

粥狀動脈硬化常見於糖尿病、高血脂症患者及煙癮者。針對這類族群的病患接受頭頸部手術及自由皮瓣顯微重建手術時，血管吻合對執行手術的醫師是一項挑戰。因為這類病患的血管十分易脆且血管內壁的堆積物也易因掉落而形成栓子進入血流而導致自由皮瓣血管栓塞。在臨床上我們將無菌鋼絲線於近端扭轉成一環狀並以持針器將近端夾住由此來提供支撐血管內壁的效果。當面對如同粥狀動脈硬化時困難縫合的血管也可以迅速完成。

關鍵字

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並列摘要

Objective: A new technique to deal with difficult end-to-end anastomosis and for anastomosis of atherosclerotic arteries in head and neck surgery by using a self-designed loop holder. Methods: A C-wire is twisted to form a loop at the tip and a needle holder is used to grasp the twisted wire. The wire is then used to guide the needle through the vessel wall during anastomosis. Minimal contact of the intima with the wire occurs. This technique is specifically used to deal with difficult end-to-end anastomosis for atherosclerotic arteries in head and neck surgery. Results: The mean follow up period was 14 days after surgery. All cases with no anastomotic complications such as arterial or venous insufficiency, artery occlusion or venous thrombosis. The diagnosis is according to the appearance and capillary refilling time of the flap. One case had re-exploration because of persistent oozing from the penrose drain for 8 hours. There were no anastomotic complications found during operation. Conclusions: The new method provides better handling of the vessel and a satisfactory completion of the anastomosis in a difficult condition.

並列關鍵字

diabetes mellitus ； hyperlipidemia ； atherosclerosis ； microvascular anastomosis

國際替代計量

A New Method of Microvascular Anastomosis for Atherosclerotic Vessel

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