PMID- 27858701
OWN - NLM
STAT- MEDLINE
DCOM- 20171116
LR  - 20221207
IS  - 1875-8622 (Electronic)
IS  - 1386-0291 (Linking)
VI  - 65
IP  - 4
DP  - 2017
TI  - Contrast-enhanced ultrasonography as a new method for assessing autonomization of 
      pedicled and microvascular free flaps in head and neck reconstructive surgery.
PG  - 317-325
LID - 10.3233/CH-16194 [doi]
AB  - OBJECTIVE: Evaluating vascular autonomization of pedicled and microvascular free 
      flaps for soft tissue reconstruction in the head and neck area by means of 
      postoperative quantitative measurement of dynamic contrast values obtained with 
      contrast-enhanced ultrasound. METHODS: 8/18 patients underwent lip reconstruction 
      with a pedicle flap, 10 patients reconstruction of other parts of the head with a 
      microvascular free transplant. Ultrasound examinations were conducted within the 
      1st postoperative week and 4 weeks after surgery. After the intravenous bolus of 
      the ultrasound contrast agent, examinations were carried out for 30 sec without 
      compression followed by 30 sec with compression of the vascular pedicle in bolus 
      and flash kinetics. Digital cine loops were analyzed off-line with a 
      quantification software (VueBox) to determine the Rise Time (RT) between flap 
      tissue with and without compression. RESULTS: Measurements showed increasing 
      autonomous perfusion, independent of the vascular pedicle. No transplant was 
      lost, but 4/10 patients with a microvascular flap and 1/8 patients with a pedicle 
      flap developed postoperative complications. RT values for the pedicled and 
      microvascular flaps obtained under compression differed significantly between the 
      1st and the 4th week (p = 0.025). CONCLUSIONS: Reliable neovascularization was 
      achieved 4 weeks postoperatively. CEUS showed to be a useful method for assessing 
      the degree of autonomization of pedicle and microvascular free flaps.
FAU - Mueller, Steffen
AU  - Mueller S
AD  - Department of Cranio-Maxillofacial Surgery, University Medical Center Regensburg, 
      Regensburg, Germany.
FAU - Wendl, Christina M
AU  - Wendl CM
AD  - Institute of Radiology, University Medical Center Regensburg, Regensburg, 
      Germany.
FAU - Ettl, Tobias
AU  - Ettl T
AD  - Department of Cranio-Maxillofacial Surgery, University Medical Center Regensburg, 
      Regensburg, Germany.
FAU - Klingelhoffer, Christoph
AU  - Klingelhoffer C
AD  - Department of Cranio-Maxillofacial Surgery, University Medical Center Regensburg, 
      Regensburg, Germany.
FAU - Geis, Sebastian
AU  - Geis S
AD  - Department of Plastic-, Hand-, and Reconstructive Surgery, University Medical 
      Center Regensburg, Regensburg, Germany.
FAU - Prantl, Lukas
AU  - Prantl L
AD  - Department of Plastic-, Hand-, and Reconstructive Surgery, University Medical 
      Center Regensburg, Regensburg, Germany.
FAU - Reichert, Torsten E
AU  - Reichert TE
AD  - Department of Cranio-Maxillofacial Surgery, University Medical Center Regensburg, 
      Regensburg, Germany.
FAU - Jung, Ernst Michael
AU  - Jung EM
AD  - Institute of Radiology, University Medical Center Regensburg, Regensburg, 
      Germany.
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Clin Hemorheol Microcirc
JT  - Clinical hemorheology and microcirculation
JID - 9709206
RN  - 0 (Contrast Media)
SB  - IM
MH  - Contrast Media/*therapeutic use
MH  - Female
MH  - Free Tissue Flaps/*blood supply
MH  - Head and Neck Neoplasms/*diagnostic imaging/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neovascularization, Pathologic
MH  - Plastic Surgery Procedures/*methods
MH  - Surgical Flaps/*blood supply
MH  - Ultrasonography/*methods
OTO - NOTNLM
OT  - Flap autonomization
OT  - contrast-enhanced ultrasound
OT  - neovascularisation
OT  - perfusion quantification
EDAT- 2016/11/20 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/11/19 06:00
PHST- 2016/11/20 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/11/19 06:00 [entrez]
AID - CH16194 [pii]
AID - 10.3233/CH-16194 [doi]
PST - ppublish
SO  - Clin Hemorheol Microcirc. 2017;65(4):317-325. doi: 10.3233/CH-16194.