Increased Patency of Artificial Microvascular Grafts Using Arteriovenous Fistula Loops: A Two-Stage Procedure for Lengthening the Pedicle of Free-Tissue Transfer

Mihye L. Choi; Martin B. Hirigoyen; Wen X. Zhang; Hubert Weinberg; Lester Silver; Jin K. Chun

doi:10.1055/s-2007-1006487

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 1996; 12(5): 283-290
DOI: 10.1055/s-2007-1006487

ORIGINAL ARTICLE

Increased Patency of Artificial Microvascular Grafts Using Arteriovenous Fistula Loops: A Two-Stage Procedure for Lengthening the Pedicle of Free-Tissue Transfer

Mihye L. Choi, Martin B. Hirigoyen, Wen X. Zhang, Hubert Weinberg, Lester Silver, Jin K. Chun

Division of Plastic Surgery, Department of Surgery, Mount Sinai Medical Center, New York, New York

Abstract

ABSTRACT

The effect of a high-flow system on the patency of artificial microvascular grafts (AMG) was investigated using arteriovenous (A-V) fistula loops made of polytetrafluoroethylene (PTFE) in a clinically useful longer length. At a second stage, the A-V loops, matured for 7 days, were used as recipient conduits for free-tissue transfer.

The patency rates of 5-cm long PTFE A-V fistula loops were compared with 5-cm and 1-cm long interpositional micrografts in a rat model. The patency rate of the loops at 7 days was 80 percent, compared to 0 percent for both the 5-cm and 1-cm interpositional grafts.

A-V fistula loops matured for 7 days in vivo were divided in their midsections and used as arterial and venous conduits (each 2.5 cm long) for free epigastric flaps (3×6 cm) raised from the contralateral groin. Sixty-seven percent (8/12) of the free flaps were viable at 7 days.

The A-V fistula loop in a high-flow system has a beneficial effect in maintaining patency of AMGs. PTFE fistula loops matured for 7 days can be used as arterial and venous conduits for microsurgical tissue transfer in rats.

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