Descending branch of the lateral circumflex femoral artery (LCFA) is commonly used pedicle for ante- rolateral thigh (ALT) flap. Oblique branch of LCFA is an alternative pedicle that can be used in micro- vascular surgery. According to review of literature and to the best of our knowledge we could not find the use of oblique branch of LCFA as a pedicle of the ALT flap in regional soft tissue reconstruction. Here we presented a case of a 55-year-old man sustaining soft tissue injury and wound over the left trochanteric and gluteal region following a road traffic accident, who was treated by the use of extended ALT pedicle flap with oblique branch of LCFA as the pedicle for reconstruction of soft tissue defect in trochanteric and gluteal regions with successful outcome.
Accidents, Traffic ; Buttocks ; Femoral Artery ; surgery ; transplantation ; Femur ; Graft Survival ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Myocutaneous Flap ; blood supply ; transplantation ; Reconstructive Surgical Procedures ; methods ; Risk Assessment ; Soft Tissue Injuries ; diagnosis ; surgery ; Surgical Flaps ; blood supply ; transplantation ; Thigh ; surgery ; Wound Healing ; physiology

The aim of this study was to determine the normal value of brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) according to age group, gender, and the presence of cardiovascular risk factors in healthy Koreans, and to investigate the association between PWV and risk factors such as prehypertension, dyslipidemia, smoking, and obesity. We measured an arterial stiffness in 110 normal subjects who were 20 to 69 yr-old with no evidence of cardiovascular disease, cerebrovascular accident or diabetes mellitus. The mean values of baPWV and cfPWV were 12.6 (+/-2.27) m/sec (13.1+/-1.85 in men, 12.1+/-2.51 in women; P=0.019) and 8.70 (+/-1.99) m/sec (9.34+/-2.13 in men, 8.15+/-1.69 in women; P=0.001), respectively. The distribution of baPWV (P<0.001) and cfPWV (P=0.006) by age group and gender showed an increase in the mean value with age. Men had higher baPWV and cfPWV than women (P<0.001). There was a difference in baPWV and cfPWV by age group on prehypertension, dyslipidemia, current smoking, or obesity (P<0.001). In multiple linear regression, age and prehypertension were highly associated with baPWV and cfPWV after adjustment for confounding factors (P<0.001). The present study showed that baPWV and cfPWV are associated with age, gender, and prehypertension in healthy Koreans.
Adult ; Age Factors ; Aged ; *Ankle Brachial Index ; Blood Pressure ; Brachial Artery/*physiology ; Cardiovascular Diseases/diagnosis/etiology/physiopathology ; Carotid Arteries/*physiology ; Female ; Femoral Artery/*physiology ; Humans ; Male ; Middle Aged ; Obesity/physiopathology ; Prehypertension/physiopathology ; Pulsatile Flow ; *Pulse Wave Analysis ; Republic of Korea ; Risk Factors ; Sex Factors ; Smoking ; Vascular Stiffness/physiology

OBJECTIVETo provide algorithmic morphological data that enables safe elevation of the flow-through perforator flap, chimeric perforator flap in the thigh.

METHODS15 fresh cadavers were injected with a modified lead oxide-gelatin mixture for three-dimensional reconstruction using a spiral computed tomography scanner and specialized volume-rendering software (MIMICS). All of specimens were then dissected by layers. Angiography and photography were used to document the precise course, size, location, and type of individual perforators in the thigh region. The surface areas of cutaneous territories and perforator zones were measured and calculate with Photoshop and Scion Image.

RESULTSThe main artery supplying the thigh is femoral artery. There are (41 +/- 4.0) perforators whose outer diameters > or = 0.5 mm. These perforators have a superficial pedicle length of (4.2 +/- 1.7) cm. The average outer diameter is (0.8 +/- 0.1) mm. Each perforator supplies an average area of (44 +/- 6.4) cm2. There are lots of truly anastomoses among perforaors to form a subcutaneous network in the thigh.

CONCLUSIONSThe volume rendering technique is very useful for showing the subcutaneous network and preoperative flap design. The thigh appears to have the greatest potential for harvesting new or modified perforator flaps, especially, flow-through perforator flap or chimeric perforator flap.

Cadaver ; Femoral Artery ; physiology ; Humans ; Perforator Flap ; blood supply ; Regional Blood Flow ; physiology ; Thigh ; blood supply ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

The present paper aims to investigate the relation between characteristic parameters of transesophageal photoelectric pulse wave in descending aorta and ambulatory artery blood pressure. The chests of ten adult experimental dogs were performed to take the photoelectric pulse wave of descending aorta transesophageally. The concurrent femoral artery invasive blood pressure was recorded simultaneously. Stepwise regression analysis method was used to study the correlation efficient between characteristic parameters of descending aorta pulse wave (H, h, h/H, g/H, At, s, H(1 + ts/td), k)and invasive artery blood pressure. The characteristic parameters, k and h/H (ratio: 90% and 80%) was proved that they had good correlation with systolic pressure; and k, H and s (ratio: 90%, 80% and 70%), had good correlation with diastolic pressure; while k and H (ratio: 90% for both) had good correlation with mean pressure. The mean values of multiple correlation coefficients of the selected characteristic parameters of descending aorta pulse wave with systolic pressure, diastolic pressure and mean pressure of femoral artery were 0.871, 0.900 and 0.856, respectively. The characteristic parameters of descending aorta pulse wave had specific correlation with systolic pressure, diastolic pressure and mean pressure.
Animals ; Aorta, Thoracic ; physiology ; Blood Pressure ; physiology ; Blood Pressure Monitoring, Ambulatory ; methods ; Dogs ; Electrophysiologic Techniques, Cardiac ; methods ; Female ; Femoral Artery ; physiology ; Male ; Pulse Wave Analysis ; methods ; Regression Analysis

OBJECTIVETo investigate the effect of interferon regulatory factors (IRFs) on neointimal formation after vascular injury in the mouse, and its possible mechanism.

METHODSVascular injury was induced by polyethylene cuff placement around the left femoral artery of IRF-1-deficient mice and C57BL/6J mice. The mRNA expressions of IRF-1, IRF-2, angiotensin II type 2 (AT2) receptor, interleukin-1 beta converting enzyme (ICE), inducible nitric oxide synthase (iNOS) were detected by RT-PCR and immunohistochemical staining.

RESULTSNeointimal formation after vascular injury was significantly greater in IRF-1-deficient mice than that in C57BL/6J mice (P<0.05). In contrast, TUNEL-positive nuclei to total nuclei in the neointima and media in vascular smooth muscle cell (VSMC) in the injured artery significantly attenuated in IRF-1-deficient mice compared to C57BL/6J mice (P<0.05). The expressions of AT2 receptor as well as pro-apoptotic genes such as ICE and iNOS in C57BL/6J mice were up-regulated in response to vascular injury, but this upregulation was attenuated in IRF-1-deficient mice.

CONCLUSIONSOur results suggest that IRF-1 induces VSMC apoptosis and inhibits neointimal formation after vascular injury at least partly due to the upregulation of AT2 receptor, ICE and iNOS expressions. These results indicate that IRF-1 exerts an inhibitory effect on neointimal formation through the induction of apoptosis in VSMCs.

Animals ; Apoptosis ; physiology ; Caspase 1 ; genetics ; metabolism ; Femoral Artery ; anatomy & histology ; pathology ; Interferon Regulatory Factor-1 ; genetics ; metabolism ; Interferon Regulatory Factor-2 ; genetics ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Muscle, Smooth, Vascular ; cytology ; metabolism ; pathology ; Nitric Oxide Synthase Type II ; genetics ; metabolism ; Platelet Endothelial Cell Adhesion Molecule-1 ; genetics ; metabolism ; Receptor, Angiotensin, Type 2 ; genetics ; metabolism ; Tunica Intima ; pathology ; physiology

BACKGROUND/AIMS: Despite the clinical importance and widespread use of pulse wave velocity (PWV), there are no standards for pulse sensors or for system requirements to ensure accurate pulse wave measurement. We assessed the reproducibility of PWV values using a newly developed PWV measurement system. METHODS: The system used in this study was the PP-1000, which simultaneously provides regional PWV values from arteries at four different sites (carotid, femoral, radial, and dorsalis pedis). Seventeen healthy male subjects without any cardiovascular disease participated in this study. Two observers performed two consecutive measurements in the same subject in random order. To evaluate the reproducibility of the system, two sets of analyses (within-observer and between-observer) were performed. RESULTS: The means+/-SD of PWV for the aorta, arm, and leg were 7.0+/-1.48, 8.43+/-1.14, and 8.09+/-0.98 m/s as measured by observer A and 6.76+/-1.00, 7.97+/-0.80, and 7.97+/-0.72 m/s by observer B, respectively. Betweenobserver differences for the aorta, arm, and leg were 0.14+/-0.62, 0.18+/-0.84, and 0.07+/-0.86 m/s, respectively, and the correlation coefficients were high, especially for aortic PWV (r=0.93). All the measurements showed significant correlation coefficients, ranging from 0.94 to 0.99. CONCLUSIONS: The PWV measurement system used in this study provides accurate analysis results with high reproducibility. It is necessary to provide an accurate algorithm for the detection of additional features such as flow wave, reflection wave, and dicrotic notch from a pulse waveform.
Adult ; Blood Flow Velocity/*physiology ; Carotid Arteries/*physiology ; Femoral Artery/*physiology ; Foot/*blood supply ; Humans ; Male ; Middle Aged ; Radial Artery/*physiology ; Reference Values ; Regional Blood Flow/*physiology ; Reproducibility of Results ; Vascular Diseases/diagnosis ; Vascular Resistance/physiology ; Young Adult

The graft diameter plays a critically important role in the long-term patency rates of bypass surgery. To clarify the influence of graft diameter on the blood flows in the femoral 2-way bypass surgery, the physiologically pulsatile flows in two femoral bypass models were simulated with numerical methods. For the sake of comparison, the models were constructed with identical geometry parameters except the different diameters of grafts. Two models with small and large grafts were studied. The boundary conditions for the simulation of blood flow were constant for both models. The maximum Reynolds number was 832.8, and the Womersley number was 6.14. The emphases of results were on the analysis of flow fields in the vicinity of the distal anastomosis. The temporal-spatial distributions of velocity vectors, pressure drop between the proximal and distal toe, wall shear stresses, wall shear stress gradients and oscillating shear index were compared. The present study indicated that femoral artery bypassed with a large graft demonstrated disturbed axial flow and secondary flow at the distal anastomosis while the axial flow at its downstream of toe was featured with larger and more uniform longitudinal velocities. Meanwhile, the large model exhibits less refluences, relatively uniform wall shear stresses, lower pressure and smaller wall shear stress gradients, whereas it does not have any advantages in the distributions of secondary flow and the oscillating shear index. In general, the large model exhibits better and more uniform hemodynamic phenomena near the vessel wall and may be effective in preventing the initiation and development of postoperative intimal hyperplasia and restenosis.
Anastomosis, Surgical ; Arterial Occlusive Diseases ; surgery ; Blood Flow Velocity ; physiology ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; methods ; Femoral Artery ; physiopathology ; surgery ; Humans ; Models, Cardiovascular ; Shear Strength ; Stress, Mechanical

OBJECTIVE: To detect the expression and activity of eNOS during the arteriogenesis of hind-limbs of pigs. METHODS: The right femoral artery was ligated, and the left femoral artery shamly operated under routine surgical procedures. Animals were sacrificed after two weeks. The expression and activity of eNOS in collateral vessels were studied by confocal immunofluorescence with antibodies against eNOS and phosphorylated eNOS (P-eNOS) respectively. RESULTS: In normal small arteries, the expression of eNOS was very low, and the staining was very weak. In growing collateral vessels, the expression of eNOS was significantly up-regulated, showing very strong positive staining. The expression of P-eNOS was also high. Dural immunostaining showed that eNOS and P-eNOS were colocalized in the endothelial cells. CONCLUSION eNOS is up-regulated and activated during arteriogenesis, suggesting that eNOS can exert the possible role in mediating the proliferation of endothelial cells and the inflammation, and contribute to the collateral vessel growth.
Animals ; Collateral Circulation ; physiology ; Endothelial Cells ; enzymology ; Endothelium, Vascular ; enzymology ; Femoral Artery ; pathology ; surgery ; Hindlimb ; blood supply ; Ligation ; Neovascularization, Physiologic ; Nitric Oxide Synthase Type III ; biosynthesis ; genetics ; Swine

OBJECTIVETo investigate pathological characteristics of gunshot wounds concomitant seawater immersion in rabbits' femoral arteries.

METHODSThirty rabbits were divided randomly into 3 groups: simple gunshot-wound group (Group I, n = 10), gunshot wound with seawater immersion for 30 mins (Group II, n = 10), and 60 mins group (Group III, n = 10). Femoral arteries were impacted by 0.38 g steel spheres fired with a 7.62 mm rifle. After being wounded, rabbits in Groups II and III were immersed in seawater for 30 or 60 mins, but those in Group I were not. At 2, 4, 6, 8, 12 hours following injury, a 40 mm segment of the artery on each side of the gunshot point were excised and observed by light and electron microscopy.

RESULTSThe patterns of arterial injuries were mainly contusion and transection. Completely transected artery was classified as primary-wound-tract area, contused area and shocked area. Compared with those in Group I, the primary-wound-tract and contused areas in Group II manifested obvious swelling in the arterial wall especially at the outside 2/3 of the media. Vacuolar structures were often seen in smooth muscle cells of the media. Intercellular space among the smooth muscle cells were filled with homogeneous acidophilic substances. Deep rugae among endothelial cells flattened or rugal folds lost their longitudinal orientation, and marked fibrin and platelet deposition were noticed. No significant difference was detected between Group II and III. The pathological changes in the shocked area were similar in 3 groups.

CONCLUSIONSFor gunshot wounds concomitant seawater immersion in rabbits' femoral arteries, there was a marked swelling of cells and intercellular space in primary-wound-tract area and contusion area. The influence of these pathological changes on surgical reparation deservers further study.

Animals ; Biopsy, Needle ; Disease Models, Animal ; Female ; Femoral Artery ; injuries ; pathology ; Immersion ; Immunohistochemistry ; Male ; Microscopy, Electron, Scanning ; Rabbits ; Random Allocation ; Seawater ; adverse effects ; Sensitivity and Specificity ; Wound Healing ; physiology ; Wounds, Gunshot ; microbiology ; pathology

AIMTo study the vasorelaxation action of oxyphenamone (Oxy) and its mechanism.

METHODSThe contractile response of isolated rabbit renal, femoral and mesentery artery preparations was determined.

RESULTSOxy was shown to inhibit the contractile force of renal, femoral and mesentery arteries induced by phenylephrine in a concentration dependent manner. The vasorelaxation produced by Oxy was not attenuated by removal of the endothelium. Oxy (10(-6)-10(-4) mol.L-1) relaxed the contractions induced by KCl 30 mmol.L-1 as well as KCl 80 mmol.L-1, but the contraction curve of KCl 80 mmol.L-1 was shifted significantly to the right. Oxy in lower concentration (10(-6) and 5 x 10(-6) mol.L-1) increased the contractions induced by Ang II, and in middle concentration (10(-5) mol.L-1) it did not affect the contractions induced by Ang II. Whereas in higher concentration (5 x 10(-5) mol.L-1) it obviously inhibited the contractions induced by Ang II.

CONCLUSIONOxy showed significant vasorelaxation to various vascular preparations, and its vasorelaxation action is endothelium independent. The mechanism of its vasorelaxations seems to be related with Ca2+ activated K+ channel (Kca channel) and Ca2+ channel in vascular smooth muscle cells but its true mechanism needs further study.

Animals ; Cardiotonic Agents ; pharmacology ; Female ; Femoral Artery ; drug effects ; physiology ; In Vitro Techniques ; Male ; Mesenteric Arteries ; drug effects ; physiology ; Organic Chemicals ; Phenylephrine ; antagonists & inhibitors ; Potassium Channels, Calcium-Activated ; metabolism ; Rabbits ; Renal Artery ; drug effects ; physiology ; Vasodilation ; drug effects ; Vasodilator Agents ; pharmacology