Johns Hopkins University, Department of Electrical and Computer Engineering, 3400 N. Charles Street, Baltimore, MD 21218, USA.
J Biomed Opt. 2013 Nov;18(11):111404. doi: 10.1117/1.JBO.18.11.111404.
Vascular and microvascular anastomoses are critical components of reconstructive microsurgery, vascular surgery, and transplant surgery. Intraoperative surgical guidance using a surgical imaging modality that provides an in-depth view and three-dimensional (3-D) imaging can potentially improve outcome following both conventional and innovative anastomosis techniques. Objective postoperative imaging of the anastomosed vessel can potentially improve the salvage rate when combined with other clinical assessment tools, such as capillary refill, temperature, blanching, and skin turgor. Compared to other contemporary postoperative monitoring modalities--computed tomography angiograms, magnetic resonance (MR) angiograms, and ultrasound Doppler--optical coherence tomography (OCT) is a noninvasive high-resolution (micron-level), high-speed, 3-D imaging modality that has been adopted widely in biomedical and clinical applications. For the first time, to the best of our knowledge, the feasibility of real-time 3-D phase-resolved Doppler OCT (PRDOCT) as an assisted intra- and postoperative imaging modality for microvascular anastomosis of rodent femoral vessels is demonstrated, which will provide new insights and a potential breakthrough to microvascular and supermicrovascular surgery.
血管和微血管吻合是重建显微外科、血管外科和移植外科的关键组成部分。术中使用提供深入视图和三维 (3-D) 成像的手术成像方式进行手术指导，有可能改善常规和创新吻合技术的术后效果。吻合血管的术后客观成像，与毛细血管再充盈、温度、苍白和皮肤弹性等其他临床评估工具相结合，有可能提高存活率。与其他当代术后监测方式（计算机断层血管造影、磁共振血管造影和超声多普勒）相比，光学相干断层扫描 (OCT) 是一种非侵入性的高分辨率（微米级）、高速、3-D 成像方式，已广泛应用于生物医学和临床应用。据我们所知，这是首次证明实时 3-D 相位分辨多普勒 OCT（PRDOCT）作为啮齿动物股血管微血管吻合术的辅助术中和术后成像方式的可行性，这将为微血管和超微血管外科提供新的见解和潜在突破。
