ArticlePlastic and reconstructive surgery. Global open2021
The Impossible Anastomosis: Intima-to-adventitia Suture Technique for Microanastomosis of Severely Calcified Arteries.
Article in Plastic and reconstructive surgery. Global open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- [Clinical application effects of vertical mattress suture combined with teardrop-shaped end-to-side arterial anastomosis technique in free flap transplantation for repairing limb wounds].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2026Article
- Microvascular Anastomosis of Calcified Vessels in a Patient with Hyperlipidemia: Meeting the Challenges and Dealing withIndian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India · 2025Article
- [Mechanical vascular anastomoses].Operative Orthopadie und Traumatologie · 2024Review
- [Microsurgical vascular suture].Operative Orthopadie und Traumatologie · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Microsurgery in patients with advanced atherosclerosis is challenging. Calcified vessels can hinder microanastomosis, which precludes free flap reconstruction in those patients. We present a case of a female patient with stage 4 peripheral artery disease who had undergone mastectomy because of invasive breast cancer. During autologous breast reconstruction with a muscle-sparing transverse rectus abdominis free flap, we experienced difficulties during microanastomosis due to complicated plaques in an extremely calcified inferior epigastric artery. Also, the intima presented completely detached from the media, leading to a collapse of the vessel lumen. To prevent curling of the intima and prolapse of the atherosclerotic plaques into the vessel lumen, the intima was sutured to the adventitia by interrupted stitches. This maneuver led to eversion of the intima and facilitated the otherwise unfeasible anastomosis. The reconstructed breast showed adequate perfusion during the postoperative course. We present a technique to facilitate microanastomosis in severely calcified and fragile arteries.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.