The natural history of microsurgical lymphovenous anastomoses: An experimental study Peter Gloviczki, M.D., Larry H. Hollier, M.D., Frederick E. Nora,

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Presentation transcript:

The natural history of microsurgical lymphovenous anastomoses: An experimental study Peter Gloviczki, M.D., Larry H. Hollier, M.D., Frederick E. Nora, M.D., Michael P. Kaye, M.D. Journal of Vascular Surgery Volume 4, Issue 2, Pages 148-156 (August 1986) DOI: 10.1016/0741-5214(86)90415-5 Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 End-to-end lymphovenous anastomosis. A = anastomosis; L = lymph vessel; V = vein. Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2a c. Microsurgical technique of end-to-end lymphovenous anastomosis. (By permission of Mayo Foundation.) Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2d g. Microsurgical technique of end-to-end lymphovenous anastomosis. (By permission of Mayo Foundation.) Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3a f. Cinelymphangiogram of patent lymphovenous anastomosis 3 months after operation. Arrows indicate passage of Ethiodol droplet in iliofemoral vein. (Note time and frame count [30/sec] at bottom of each picture.) A = anastomosis; L = lymph vessel. Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3g l. Cinelymphangiogram with simultaneous phlebogram in same animal (Fig. 3a-f) confirms passage of Ethiodol in vein. (Note time and frame count [30/sec] at bottom of each picture.) A = anastomosis; L = lymph vessel. Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Scanning electron micrographs. a, Patent end-to-end lymphovenous anastomosis 2 weeks after operation (original magnification, ×70). b, Suture, free of endothelium, is visible at anastomosis (original magnification, ×200). A = anastomosis; L = lymph vessel; S = suture; V = vein; VV = venous valve. Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 a and b, Scanning electron micrographs of patent anastomosis 4 weeks after operation. Endothelial cells cover suture line. A = anastomosis; L = lymph vessel; LV = lymphatic valve; S = suture; V = vein. (a, original magnification, ×10; b, original magnification, ×200.) Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 Scanning electron micrograph of patent anastomosis 6 weeks after operation. Fibrin bridges cover anastomotic line. Note partially reendothelialized fibrin strips. A = anastomosis; F = fibrin; L = lymph vessel; V = vein (original magnification, ×30). Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 7 Scanning electron micrograph of patent anastomosis 3 months after operation. Endothelium is intact, and no fibrin deposition is seen. A = anastomosis; L = lymph vessel; S = suture at outer surface of the anastomosis; V = vein (original magnification, ×90). Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 8 Scanning electron micrograph of patent but narrowed anastomosis 3 months after operation. A = anastomosis; L = lymph vessel; LV = lymphatic valve; V = vein; VV = venous valve (original magnification, ×10). Journal of Vascular Surgery 1986 4, 148-156DOI: (10.1016/0741-5214(86)90415-5) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions