Évaluation du flux sanguin par imagerie en résonance magnétique fonctionnelle après anastomoses artérielles assistées par laser diode 1,9 μm
Tutkimustuotos › › vertaisarvioitu
|Julkaisu||Annales de Chirurgie Plastique Esthétique|
|DOI - pysyväislinkit|
|Tila||Julkaistu - joulukuuta 2011|
Introduction: The most important factor for successful free-flap transfer and replantations is a well-executed anastomosis. The aim of this study is to assess blood flow after laser assisted arterial microanastomosis (LAMA) using a 1.9μm diode laser. Materials and methods: LAMA was performed on a series of 10 carotidis on Wistar rats. Two 10/0 stay sutures and a standard laser tissue welding technique (λ: 1.9μm; power: 120. mW) were used. Similarly, a series of 10 conventional arterial anastomosis were performed (CSMA). For the two groups, contralateral non-operated carotidis were used as control. A positioning sequence, an anatomical sequence, an angiographic sequence and a flow sequence were performed 1 day after operation and then after 1, 4 and 8 weeks. Results: The arterial patency rate was 100% at the time of surgery. The mean clamping time was 7.2. min in the LAMA group compared to 10.7. min in the CSMA group. In the angiographic sequence, there were no aneurysms in both groups for all observation periods. At postoperative day 1, the mean loss of blood flow at the level of anastomosis in the LAMA group was 6% compared with 14% in the CSMA group. After 1, 4 and 8 weeks, there was an unhooking of the blood flow in the CSMA group: the loss of blood flow was 23%, 27% and 31% respectively, compared with 10%, 12% and 13% in the LAMA group. Moreover, one case of thrombosis was observed in the CSMA group after 1 week. Conclusion: The flow-MRI emphasizes that 1.9μm diode laser assisted microvascular anastomosis appears to be a consistent and reliable technique. These results show that 1.9μm diode laser assisted microvascular anastomosis has potential for further development in the near future.