• Title/Summary/Keyword: Vein graft

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VEIN GRAFT REPAIR COMPARED WITH NERVE GRAFTING FOR INFERIOR ALVEOLAR NERVE REGENERATION IN RABBITS (가토 하치조신경 재건에 있어 정맥이식통로를 이용한 신경재생유도에 관한 실험적 연구)

  • Shin, Il;Kim, Myung-Jin;Nam, Il-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.3
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    • pp.270-278
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    • 2000
  • This study was conducted to compare the vein graft with the nerve graft, and evaluated the availability of the vein graft on the reconstruction of the inferior alveolar nerve defect. The experimental animals were 12 rabbits weighing $1.5{\sim}2.0kg$, divided into 3 groups : sham operation group, vein conduit group and nerve graft group. All nerves were excised and histomorphometric analysis was performed at 2, 4, 6, 12, 16 weeks after operation. The obtained results were as follows. 1. Histologic examination revealed the regenerated nerve fibers within the lumen of the vein graft and nerve graft at 6 weeks after repair. 2. Axon diameter was significantly larger in nerve graft group(p<0.05) than in vein graft group at 6weeks, and larger in nerve graft group than in vein graft group at 16weeks. 3. Axon density was higher in the vein graft group at 16 weeks. 4. The myelin of the regenerated nerve fibers in distal segment of the vein graft group was thick, approaching the proximal segment at 16weeks. This means remyelination in distal segment in the vein graft group. These results suggested that autogenous vein graft may be used as an alternative to autogenous nerve graft.

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Digital Replantation Using Autogenous Vein Graft (자가 정맥 이식을 이용한 수지 접합술)

  • Kim, Yong-Jin;Kim, Hyung-Kun;Kim, Hyung-Ju;Park, Jin-Chul
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.73-79
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    • 1998
  • We carried out 107 replantations of amputated digits since last 1988. Among them, clean Gillotine amputation was 19 digits, mild crush amputation was 51 digits, severe crush amputation was 28 digits and avulsion type amputation was 9 digits. Vein grafts were used on 24 of these cases. The donor site of the vein graft was the volar aspect of the ipsilateral wrist or lower forearm. The average length of the vein graft was 1.8cm(1.0-3.0cm) and the average diameter of the vein graft was 1.5mm(1.0-2.0mm). Sixty-one of 107 digits were successfully replanted for an 57% success rate. The survival rate of the replantation using the vein graft was 66.7%. We analysed the functional results of the successfully replanted digits according to Nakamura and Tamai's criteria. The functional results of the replantated digits using vein graft were better than that of without using vein graft(more than fair results, 81.2% vs 73.3%). We conclude that the jucidious use of autogenous vein grafts in digital replantation surgery will improve the survival rate and promote the functional result.

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Bypass of Superior Vena Cava with Spiral Vein Graft (Spiral Vein Graft를 이용한 상대정맥 우회로 조성술-치험 1례-)

  • Hwang, Su-Hui;Kim, Byeong-Jun;Jeong, Seong-Un
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.344-347
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    • 1997
  • A 49-year-old female patient who had obstruction of superior vents cave(SVC) with SVC syndrome was successfully managed by bypass operation of superior vents cava with spiral vein graft. A composite spiral vein graft was placed between the right innominate vein and the right atrium to bypass the occluded SVC. The graft was constructed from the patient's own saphenous vein, which was split longitudinally and wrapped around a stent in spiral fashion and the edges of the vein were sutured together to form a large autogenous conduit. The patient was relieved o SVC obstructive symtoms and signs and discharged 21 days postoperatively without any complication.

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Treatment of Postoperative Tarsal Tunnel Syndrome with Autogeneous Vein Wrapping Graft (수술 후 발생한 족근관 증후군의 자가 복재 정맥 이식술을 이용한 치료)

  • Kim, J-Young;Park, Hyun-Kyoo;Lee, Kyung-Tai;Young, Ki-Won;Jeong, Ju-Seon
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.109-112
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    • 2006
  • Management of postoperative tarsal tunnel syndrome is a perplexing problem to the surgeons. Autogenous vein wrapping graft is a effective method to decompress the tarsal tunnel. We treated 2 cases of postoperative tarsal tunnel syndrome with autogenous saphenous vein wrapping graft technique, and could get good results. Autogenous vein wrapping graft seems to be a good technique for tarsal tunnel syndrome with severe adhesion, particularly after surgery, and postoperative nerve adhesion can be prevented.

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Clinical Application of Great Saphenous Vein Graft in the Oral and Maxillofacial Reconstruction (구강악안면 재건을 위한 대복재정맥의 유용성)

  • Park, Jung-Min;Kim, Soung-Min;Seo, Mi-Hyun;Kang, Ji-Young;Myoung, Hoon;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.140-147
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    • 2012
  • Microvascular reconstruction, in the oral and maxillofacial regions, is a widely accepted as the best way to overcome the complex oral cavity defects. Many patients requiring composite reconstructions have been treated previously with radiation therapy, chemotherapy, selective and/or functional neck dissection or any of these combinations. In many cases of these patients, inadequate neck vessels for the microanastomosis of free flap are available, due to a lack of recipient vessels in the neck, poor vessel quality or vessel caliber mismatch. To achieve a tension-free anastomosis, vein grafting must be considered to span the vessel gap between the free flap pedicle and the recipient neck vessels. Although most microsurgeons believed that interpositional grafts are to be avoided due to vessel thrombosis and increased number of necessary microanastomosis, we, authors have some confidence of equivalency between reconstruction with and without interpositional saphenous vein graft. The great saphenous vein, also known as the long saphenous vein, is the large subcutaneous superficial vein of the leg and thigh. It joins with the femoral vein in the region of femoral triangle at the saphenofemoral junction, and coursed medially to lie on the anterior surface of the thigh before entering an opening in the fascia lata, called the saphenous opening. For a better understanding of the great saphenous vein graft for the interpositional vessel graft in the oral cavity reconstructions, and an avoidance of any uneventful complications during these procedures, the related surgical anatomies with their harvesting tips are summarized in this review article in the Korean language.

Nerve Regeneration Using a Vein Graft Conduit filled with Hyaluronic Acid in a Rat Model (흰쥐 모델에서 하이알루론산을 채운 정맥도관의 신경재생에 관한 연구)

  • Suh, Bo Ik;Kim, Sang Woo;Chung, Ho Yun;Kim, Il Hwan;Yang, Jung Dug;Park, Jae Woo;Cho, Byoung Chae
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.279-284
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    • 2007
  • Purpose: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. Methods: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups Results: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was $-52.5{\pm}8.2$ in group I, $-68.1{\pm}4$ in group II, $-55.3{\pm}7.9$ in group III. In electrophysiological study, NCV(nerve conduction velocity) was $26.71{\pm}3.11m/s$ in group I, $17.94{\pm}4.35m/s$ in group II, $25.69{\pm}2.81m/s$ in group III. The functional recovery in group I and III was superior to that the group II statistically(p < 0.05) Under electromicroscopic study, the number of the myelinated axons were $1419.1{\pm}240$ in group I, $921.7{\pm}176.8$ in group II, $1322.2{\pm}318$ in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). Conclusion: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.

A Study in Bridging Sciatic Nerve Defects with Combined Skeletal Muscle and Vein Conduit in Rats (백서의 좌골신경에서 정맥 및 골격근을 이용한 결손신경 봉합술에 대한 연구)

  • Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.29-38
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    • 1997
  • A peripheral nerve when approximation of the ends imparts tension at the anastomosis and with a relatively long segment defect after excision of neuroma and neurofibroma cannnot be repaired by early primary suture. The one of the optimistic reconstruction method of severed peripheral nerves is to restore tension-free continuity at the repair site putting an autogenous nerve graft into the neural gap despite of ancipating motor or sensory deficit of the donor nerve area. To overcome the deficit of the autogenous nerve graft, several other conduits supplying a metabolically active environment which is able to support axon regeneration and progression, providing protection against scar invasion, and guiding the regrowing axons to the distal stump of the nerve have been studied. An author have used ipsilateral femoral vein, ipsilateral femoral vein filled with fresh thigh muscle, and autogenous sciatic nerve for the sciatic nerve defect of around 10 mm in length to observe the regeneration pattern in rat by light and electron microscopy. The results were as follows. 1. Light microscopically regeneration pattern of nerve fibers in the autogenous graft group was more abundant than vein graft and vein filled with muscle group. 2. On ultrastructural findings, the proxial end of the graft in various groups showed similar regenerating features of the axons, myelin sheaths, and Schwann cells. The fascicular arrangement of the myelinated and unmyelinated fibers was same regardless of the type of conduits. There were more or less increasing tendency in the number and the diameter of myelinated fibers correlated with the regeneration time. 3. In the middle of the graft, myelinated nerve fibers of vein filled with muscle group were more in number and myelin sheath was thinner than in the venous graft, but the number of regenerating axons in autogenous nerve graft was superior to that in both groups of the graft. The amount of collagen fibrils and amorphous materials in the endoneurial space was increased to elapsed time. 4. There was no difference in regenerating patterns of the nerve fibers of distal end of the graft. The size and shape of the myelinated nerve fbers were more different than that of proximal and middle portion of the graft. From the above results, the degree of myelination and regenerating activity in autogenous nerve is more effective and active in other types of the graft and there were no morphological differences in either ends of the graft regardless of regeneration time.

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Portal vein reconstruction in pediatric liver transplantation using end-to-side jump graft: A case report

  • Jaewon Lee;Nam-Joon Yi;Jae-Yoon Kim;Hyun Hwa Choi;Jiyoung Kim;Sola Lee;Su young Hong;Ung Sik Jin;Seong-Mi Yang;Jeong-Moo Lee;Suk Kyun Hong;YoungRok Choi;Kwang-Woong Lee;Kyung-Suk Suh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.313-316
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    • 2023
  • Attenuated portal vein (PV) flow is challenging in pediatric liver transplantation (LT) because it is unsuitable for classic end-to-end jump graft reconstruction from a small superior mesenteric vein (SMV). We thus introduce a novel technique of an end-to-side jump graft from SMV during pediatric LT using an adult partial liver graft. We successfully performed two cases of end-to-side retropancreatic jump graft using an iliac vein graft for PV reconstruction. One patient was a 2-year-old boy with hepatoblastoma and a Yerdel grade 3 PV thrombosis who underwent split LT. Another patient was an 8-month-old girl who had biliary atresia and PV hypoplasia with stenosis on the confluence level of the SMV; she underwent retransplantation because of graft failure related to PV thrombosis. After native PV was resected at the SMV confluence level, an end-to-side reconstruction was done from the proximal SMV to an interposition iliac vein. The interposition vein graft through posterior to the pancreas was obliquely anastomosed to the graft PV. There was no PV related complication during the follow-up period. Using a jump vascular graft in an end-to-side manner to connect the small native SMV and the large graft PV is a feasible treatment option in pediatric recipients with inadequate portal flow due to thrombosis or hypoplasia of the PV.

Avoiding Venous Anastomotic Dehiscence of an Arteriovenous Graft in a Super-Obese Patient

  • Bae, Miju
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.417-419
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    • 2020
  • Surgeons avoid creating arteriovenous fistulae in obese patients owing to deep vessels, cannulation complications, and inconsistent outcomes. We describe placing an arteriovenous polytetrafluoroethylene (PTFE) graft between the brachial artery and axillary vein to avoid these complications. A 39-year-old super-obese woman with end-stage renal disease had undergone several hemodialysis access procedures on both arms. We traced the course of the arteriovenous graft course with the patient sitting and lying down. The ideal course was more accurate with the patient sitting; thus, the patient sat when the course was drawn, before lying on the operating bed. The PTFE graft was placed between the right brachial artery and axillary vein, according to the course in the opposite arm. No anastomotic dehiscence or pseudoaneurysm has taken place during 2 years of follow-up. In super-obese patients, the ideal course for arteriovenous grafts should be drawn while they are sitting, avoiding skin folds. This tip could avoid anastomotic dehiscence and pseudoaneurysm between the axillary vein and a PTFE graft.

Crossover bypass in the Obstruction of the Common Iliac Vein Using with Saphenous Vein Graft - A Report of Case - (외상성 총장골정맥폐쇄에서 Palma 씨 수술치험 1례)

  • 이종락
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.337-341
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    • 1989
  • A 40-year-old male developed the swelling of the right leg one month after trauma on cycling. Conservative measures to relieve the swelling of the right leg for three months were failed. Venogram showed complete obstruction of the right common iliac vein. Crossover bypass [Palmas operation] with great saphenous vein graft for relief of venous stasis of the right leg was performed. Postoperatively, the swelling of the right leg was subsided and able to walk without edema of the right leg.

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