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DOI: 10.5935/2177-1235.2024RBCP0905-PT
Immediate intermittent compression over vascular anastomosis: a new technique to prevent thrombosis?
Article in several languages: português | English
▪ ABSTRACT
Introduction:
This study aims to evaluate the effect of immediate intermittent compression on microsurgical arterial anastomoses in comparison with fixed compression and only observation in an experimental laboratory.
Methods:
The two femoral arteries of twelve male Wistar rats were sectioned and reanastomosed to compare patency at 30 minutes and 7 days. Group I: immediate intermittent compression was performed over the anastomosis for 60 s; group II: a fixed compression was maintained immediately after the anastomosis for 60 s; group III: after completion of the anastomosis, no additional intervention was performed. In addition to the patency assessment, the animals were weighed and the operated arterial diameters were measured.
Results:
Twenty-four femoral arteries were examined. Initial average weights of the rats in groups I, II, and III were 243.8g, 254.6g, and 260.4g, respectively, while the final weights were 264.4g, 281g, and 282.1g (p<0.001), respectively; mean diameter of the approached arteries was 0.89, 0.88, and 0.90mm, respectively, and the anastomoses (time in minutes) were 25.6, 24.5, and 24.5, respectively; final patencies after 7 days were 62.5% (p=0.07), 25% (p=0.48), and 50% (p=0.13), respectively.
Conclusion:
Immediate intermittent compression can be performed at the end of microsurgical arterial anastomoses without affecting the final patency of the procedure.
Keywords:
Arteriovenous anastomosis - Microsurgery - Plastic surgery procedures - Thrombosis - Rats, WistarInstitution: Hospital das Clínicas da Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil.
Publication History
Received: 22 November 2023
Accepted: 04 February 2024
Article published online:
20 May 2025
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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BALDUINO FERREIRA DE MENEZES NETO, MATHEUS SCURACCHIO FERNANDES, LUCAS VANNUCHI MAGNANI, FAUSTO VITERBO. Compressão intermitente imediata sobre anastomose vascular: Uma nova técnica para prevenir trombose?. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2024; 39: 217712352024rbcp0905pt.
DOI: 10.5935/2177-1235.2024RBCP0905-PT
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REFERÊNCIAS
- 1 Rickard RF, Hudson DA. A history of vascular and microvascular surgery. Ann Plast Surg 2014; 73 (04) 465-472
- 2 Viterbo F. A importância da microcirurgia na cirurgia plástica. Rev Bras Cir Plást 2012; 27 (01) 2
- 3 Cunha MS, Ramos RS, Torres ALG, Souza DAM, Agra IMG, Eulálio JN. Aplicação da microcirurgia no serviço de cirurgia plástica da Universidade Federal da Bahia: análise dos resultados e complicações. Rev Col Bras Cir 2005; 32 (06) 297-303
- 4 Pessoa BBGP, Pessoa SGP. Treinamento em microanastomoses utilizando tubos de látex. Acta Cir Bras 2002; 17 (02) 143-146
- 5 Dias IS, Pessoa SGP, Benevides AN, Macêdo JE. Treinamento inicial em microcirurgia. Rev Bras Cir Plást 2010; 25 (04) 595-599
- 6 Brown E, Suh HP, Han HH, Pak CJ, Hong JP. Best new flaps and tips for success in microsurgery. Plast Reconstr Surg 2020; 146 (06) 796-807
- 7 Colakoglu S, Tebockhorst S, Chong TW, Mathes DW. Patient safety in microvascular plastic surgery. J Reconstr Microsurg 2019; 35 (09) 631-639
- 8 Abi-Rafeh J, Zammit D, Mojtahed Jaberi M, Al-Halabi B, Thibaudeau S. Nonbiological Microsurgery Simulators in Plastic Surgery Training: A Systematic Review. Plast Reconstr Surg 2019; 144 (03) 496e-507e
- 9 Kinshoku MR, Rodriguez CAL, Fidalgo RS, Duran CCG, Leme PLS, Duarte IS. Rational use of animal models for research and microsurgery training. Rev Col Bras Cir 2012; 39 (05) 414-417
- 10 Mathon B. Learning vascular microsurgical techniques on an animal model. Neuro-Chirurgie 2014; 60 (05) 227-233
- 11 Mücke T, Wolff C, von Düring M, Mitchell DA, Ritschl LM, Fichter AM. Form and size matter: Increased risk of thrombosis in microvessels with surgically created endothelial lesions. J Reconstr Microsurg 2017; 33 (01) 40-44
- 12 Kaidar-Person O, Rosenthal RJ, Wexner SD, Szomstein S, Person B. Compression anastomosis: history and clinical considerations. Am J Surg 2008; 195 (06) 818-826
- 13 Chen LE, Seaber AV, Urbaniak JR. Thrombosis and thrombolysis in crushed arteries with or without anastomosis: a new microvascular thrombosis model. J Reconstr Microsurg 1996; 12 (01) 31-38
- 14 Menezes Neto BF, Oliveira Neto FV, Secanho MS, Carvalho LB, Moragas WR, Fernandes MS. Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery. Acta Cir Bras 2021; 36 (08) e360807
- 15 Yoon AP, Jones NF. Critical time for neovascularization/angiogenesis to allow free flap survival after delayed postoperative anastomotic compromise without surgical intervention: A review of the literature. Microsurgery 2016; 36 (07) 604-612
- 16 Shaughness G, Blackburn C, Ballestín A, Akelina Y, Ascherman JA. Predicting Thrombosis Formation in 1-mm-Diameter Arterial Anastomoses with Transit-Time Ultrasound Technology. Plast Reconstr Surg 2017; 139 (06) 1400-1405
- 17 Cox GW, Runnels S, Hsu HS, Das SK. A comparison of heparinised saline irrigation solutions in a model of microvascular thrombosis. Br J Plast Surg 1992; 45 (05) 345-348
- 18 Malm K, Dahlbäck B, Arnljots B. Low-molecular-weight heparin (dalteparin) effectively prevents thrombosis in a rat model of deep arterial injury. Plast Reconstr Surg 2003; 111 (05) 1659-1666
- 19 Ogawa H, Kusumoto J, Nomura T, Hashikawa K, Terashi H, Sakakibara S. Wire Myography for Continuous Estimation of the Optimal Concentration of Topical Lidocaine as a Vasodilator in Microsurgery. J Reconstr Microsurg 2021; 37 (06) 541-550
- 20 Yokoyama T, Kadota S, Takeuchi K, Tosa Y, Kadomatsu K, Shimizu Y. et al. Changes in the blood flow and prevention of vasospasm of the femoral artery by topical application of lidocaine in rats. Ann Plast Surg 2011; 67 (02) 178-183
- 21 Chung TL, Pumplin DW, Holton LH. 3rd, Taylor JA, Rodriguez ED, Silverman RP. Prevention of microsurgical anastomotic thrombosis using aspirin, heparin, and the glycoprotein IIb/IIIa inhibitor tirofiban. Plast Reconstr Surg 2007; 120 (05) 1281-1288
- 22 Yates YJ, Farias CL, Kazmier FR, Puckett CL, Concannon MJ. The effect of tirofiban on microvascular thrombosis: crush model. Plast Reconstr Surg 2005; 116 (01) 205-208
- 23 İğde M, Onur Öztürk M, Yaşar B, Hakan Bulam M, Ergani HM, Ünlü RE. Antithrombotic effect of epigallocatechin gallate on the patency of arterial microvascular anastomoses. Arch Plast Surg 2019; 46 (03) 214-220
- 24 Kim SH, Chang HW, Choi TH, Kim JH, Son D, Han K. et al. Cilostazol effectively reduces the decrease of flow volume in a thrombotic anastomosis model in a rat: a novel application of ultrasonography for evaluation. Ann Plast Surg 2010; 64 (04) 482-486
- 25 Kronen G, Ferder M, Hunzicker K, Strauch B. The use of pentoxifylline in microvascular surgery. J Reconstr Microsurg 1994; 10 (01) 17-20
- 26 Nasiri M, Kardar MH. Effect of Ethanol on Micro-Vessels Diameter and Prevention of Thrombosis. World J Plast Surg 2019; 8 (02) 249-253
- 27 Fathi M, Fathi H, Mazloumi M, Khalilzadeh O, Amanpour S, Meysamie A. et al. Preventive effect of botulinum toxin A in microanastomotic thrombosis: a rabbit model. J Plast Reconstr Aesthet Surg 2010; 63 (10) e720-4
- 28 Janz BA, Thomas PR, Fanua SP, Dunn RE, Wilgis EF, Means Jr. KR. Prevention of anastomotic thrombosis by botulinum toxin B after acute injury in a rat model. J Hand Surg Am 2011; 36 (10) 1585-1591
- 29 Bilgin SS, Topalan M, Ip WY, Chow SP. Effect of torsion on microvenous anastomotic patency in a rat model and early thrombolytic phenomenon. Microsurgery 2003; 23 (04) 381-386
- 30 Salgarello M, Lahoud P, Selvaggi G, Gentileschi S, Sturla M, Farallo E. The effect of twisting on microanastomotic patency of arteries and veins in a rat model. Ann Plast Surg 2001; 47 (06) 643-646