Evaluation of microvascular anastomosis using real-time, ultra-high-resolution, fourier domain doppler optical coherence tomography

Yong Huang, Dedi Tong, Shan Zhu, Lehao Wu, Qi Mao, Zuhaib Ibrahim, W. P.Andrew Lee, Gerald Brandacher, Jin U. Kang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Evolution in microsurgical techniques and tools has paved the way for supermicrosurgical anastomoses, with vessel diameters often approaching below 0.8 mm in the clinical realm and even smaller (0.2 to 0.3 mm) in murine models. Several imaging and monitoring devices have been introduced for postoperative monitoring, but intraoperative guidance, assessment, and predictability have remained limited to binocular optical microscopy and the surgeon's experience. The authors present a high-resolution, real-time, three-dimensional imaging modality for intraoperative evaluation of luminal narrowing, thrombus formation, and flow alterations. Methods: An imaging modality that provides immediate, in-depth, high-resolution, three-dimensional structure view and flow information of the anastomosed site, called phase-resolved Doppler optical coherence tomography, was developed. Twenty-two mouse femoral artery anastomoses and 17 mouse venous anastomoses were performed and evaluated. Flow status, vessel inner lumen three-dimensional structure, and early thrombus detection were analyzed based on imaging results. Predictions formed correlated with actual long-term surgical outcomes. Eventually, four cases of mouse orthotopic limb transplantation were carried out, and predicted long-term patency based on imaging results was confirmed by actual results. Results: The assessments based on high-resolution three-dimensional visualization of the vessel flow status and inner lumen provided by phase-resolved Doppler optical coherence tomography show 92 percent sensitivity and 90 percent specificity for arterial anastomoses and 90 percent sensitivity and 86 percent specificity for venous anastomoses. Conclusions: Phase-resolved Doppler optical coherence tomography is an effective evaluation tool for microvascular anastomosis. It can predict the long-term vessel patency with high sensitivity and specificity.

Original languageEnglish (US)
Pages (from-to)711e-720e
JournalPlastic and reconstructive surgery
Volume135
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

Fingerprint

Optical Coherence Tomography
Thrombosis
Intraoperative Monitoring
Three-Dimensional Imaging
Femoral Artery
Microscopy
Extremities
Transplantation
Sensitivity and Specificity
Equipment and Supplies

ASJC Scopus subject areas

  • Surgery

Cite this

Evaluation of microvascular anastomosis using real-time, ultra-high-resolution, fourier domain doppler optical coherence tomography. / Huang, Yong; Tong, Dedi; Zhu, Shan; Wu, Lehao; Mao, Qi; Ibrahim, Zuhaib; Lee, W. P.Andrew; Brandacher, Gerald; Kang, Jin U.

In: Plastic and reconstructive surgery, Vol. 135, No. 4, 01.04.2015, p. 711e-720e.

Research output: Contribution to journalArticle

Huang, Yong ; Tong, Dedi ; Zhu, Shan ; Wu, Lehao ; Mao, Qi ; Ibrahim, Zuhaib ; Lee, W. P.Andrew ; Brandacher, Gerald ; Kang, Jin U. / Evaluation of microvascular anastomosis using real-time, ultra-high-resolution, fourier domain doppler optical coherence tomography. In: Plastic and reconstructive surgery. 2015 ; Vol. 135, No. 4. pp. 711e-720e.
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