ABSTRACT
The problem of vesselsize discrepancy is still unsolved in microvascular-free tissue
transfers. In an effort to develop a technique perioperatively to dilate smaller vessel
diameters, the authors utilized a catheter customarily used in coronary angioplasties,
the percutaneous transluminal coronary angioplasty (PTCA) catheter. Twenty New Zealand
rabbits were divided into two groups: Group 1 consisted of 14 experimental animals;
Group 2 of six control animals. In both groups, a segmental defect of 2 cm was created
in the proximal portion of the femoral artery just below the inguinal ligament, where
the vessel diameter is 2.0 ± 0.1 mm. In Group 1 animals, an arterial graft was harvested
from the superficial femoral artery in the contralateral lower extremity, where the
vessel diameter is 1.0 ± 0.1 mm. The arterial graft along its entire length was dilated,
using a PTCA catheter up to 2 mm in diameter. The duration of dilation was 3 min with
pressure applied at 2.5 atm. Before and following dilation, sections were obtained
from both ends of the graft for histologic comparison. The grafts were then interposed
within the defect and microvascular anastomoses were performed. In the control group,
an arterial graft of the same length as in the experimental group was harvested from
the contralateral upper femoral region, where the vessel diameter is 2.0 ± 0.1 mm.
These grafts were then interposed within the defect and microsurgically anastomosed.
Seven days later, the patency of the anastomoses was evaluated in both groups. In
13 of 14 rabbits in the experimental group, the anastomoses were patent and the arterial
grafts maintained their dilated diameters (2 mm). In all six control animals, the
anastomoses were patent. A statistical comparison of vessel patency using Fischer's
exact chi-square test showed no significant differences between the experimental and
control groups (p = 0.7). Histologically, the dilated arteries demonstrated intact endothelial layers.
