Izadpanah Amin, Alt Eckhard U, Izadpanah Reza
From the Applied Stem Laboratory, Department of Medicine, Heart and Vascular Institute, Tulane University Health Science Center, New Orleans, La.
Division of Plastic and Reconstructive Surgery, Tulane University School of Medicine, New Orleans, La.
Plast Reconstr Surg Glob Open. 2024 Jul 30;12(7):e6009. doi: 10.1097/GOX.0000000000006009. eCollection 2024 Jul.
Despite the critical roles of nondominant perforators, choke vessels, and direct and indirect linking vessels in flap vascularity, current models of flap perfusion focus on a primary large caliber perforators. The delay phenomenon, microvascularization, neovascularization, and vascular evolution, which depend on smaller caliber vessels, remain unaccounted for. We propose that the "circulasome" consists of the sum of the entire vascular components of a given region, such that the region is supplied by a primary supplying vessel. The circulasome represents one of the indices of flap supply and is proportional to the angiogenic potential of the region and the vascular substrate capable of promoting growth of vascular networks. By accounting for both the primary flap supplying vessel and secondary vascular structures, the circulasome provides a unifying explanation for neovascularization, delay phenomenon, angiosome and perforasome theories, and vascular evolution in flaps.
尽管非优势穿支血管、阻塞血管以及直接和间接连接血管在皮瓣血管形成中起着关键作用，但目前的皮瓣灌注模型主要关注主要的大口径穿支血管。而依赖于较小口径血管的延迟现象、微血管化、新生血管形成和血管演化仍未得到解释。我们提出，“循环体”由给定区域的整个血管成分总和组成，使得该区域由一条主要供血血管供应。循环体代表皮瓣供血的指标之一，并且与该区域的血管生成潜力以及能够促进血管网络生长的血管基质成正比。通过兼顾皮瓣主要供血血管和次要血管结构，循环体为皮瓣中的新生血管形成、延迟现象、血管体和穿支体理论以及血管演化提供了统一的解释。
