Features | Partner Sites | Information | LinkXpress
Sign In
AMPRONIX
SCHILLER AG
TERARECON, INC.

Following Face Transplantation Surgery, Blood Vessels Shown to Reorganize

By Medimaging International staff writers
Posted on 24 Dec 2013
Image: CT angiography after face transplantation. Recipient’s left lingual artery was ligated, but the portion distal to the ligation (rectangular area) was still enhanced via blood flow from the contralateral side (arrow) (Photo courtesy of RSNA).
Image: CT angiography after face transplantation. Recipient’s left lingual artery was ligated, but the portion distal to the ligation (rectangular area) was still enhanced via blood flow from the contralateral side (arrow) (Photo courtesy of RSNA).
Image: CT angiography before and after face transplantation. Donor’s facial artery (yellow) was successfully anastomosed—or reconnected—to the recipient’s vessel (Photo courtesy of RSNA).
Image: CT angiography before and after face transplantation. Donor’s facial artery (yellow) was successfully anastomosed—or reconnected—to the recipient’s vessel (Photo courtesy of RSNA).
Image: CT angiography after face transplantation. Donor’s external carotid artery (pink) was successfully anastomosed to the recipient’s vessel (rectangular area). Branches distal to the ligation (white line) receive blood flow from collateral vessels (arrows) (Photo courtesy of RSNA).
Image: CT angiography after face transplantation. Donor’s external carotid artery (pink) was successfully anastomosed to the recipient’s vessel (rectangular area). Branches distal to the ligation (white line) receive blood flow from collateral vessels (arrows) (Photo courtesy of RSNA).
In face transplant recipients, new findings have shown that blood vessels reorganize themselves, leading to a better determination of the biologic alterations that occur after full-face transplantation.

The study’s findings were presented December 2013 at the annual meeting of the Radiological Society of North America (RSNA) held in Chicago (IL, USA). Face transplantation is a recent development in reconstructive surgery for patients who have lost some or all of their face from injury or disease. The first full face transplantation in the United States was performed at Brigham and Women’s Hospital (BGH; Boston, MA, USA) in 2011. Hospital specialists next performed full-face transplantations on three additional patients.

Surgeons, during the procedure, connect the patient’s major arteries and veins to those from a donor face (called a facial allograft) to safeguard healthy circulation in the transplanted tissue. Because the technology is new, not much is known about the vascular changes that help blood perfuse into the transplanted tissue. The development of new blood vessel networks in transplanted tissue is critical to the success of face transplant surgery.

“All three patients included in this study at Brigham and Women's maintain excellent perfusion, or blood flow, the key element of viability of the facial tissues and the restoration of form and function to those individuals who otherwise had no face,” said study co-uthor Frank J. Rybicki, MD, PhD, FAHA, FACR, director of BGH’s Applied Imaging Science Laboratory. “We assumed that the arterial blood supply and venous blood return was simply from the connections of the arteries and the veins at the time of the surgery.”

Dr. Rybicki and Kanako K. Kumamaru, MD, PhD, research fellow at Brigham and Women’s Applied Imaging Science Laboratory, used 320-detector row dynamic computed tomography angiography (CTA) to examine the facial allografts of the three patients one year after successful transplantation. The CTA technology offers imaging over 16 cm of coverage, enabling the researchers to view collateralization, a process in which the body stimulates existing blood vessels to elongate, widen, and form new connections. Collateralization frequently results from anastomoses. “The key finding of this study is that, after full face transplantation, there is a consistent, extensive vascular reorganization that works in concert with the larger vessels that are connected at the time of surgery,” Dr. Kumamaru said.

The findings revealed that the new blood vessel networks course posteriorly, or toward the ears and even farther behind the head, in addition to the large arteries and veins that course anteriorly in the face, or close to the jaw. “We have found that since the vessels more commonly associated with the back of the head are critical to maintain the perfusion via vascular reorganization, it is essential to visualize these vessels and determine that they are normal preoperatively,” Dr. Kumamaru said. “Patients under consideration for face transplantation have universally had some catastrophic defect or injury.”

The investigators noted that the findings could help enhance surgical planning and evaluation of potential complications in face transplant patients. For instance, earlier published studies recommended the joining of multiple arteries and veins to provide sufficient blood flow in the facial allograft. However, performing these multiple connections causes longer operation time compared with a single anastomosis.

“Our findings support the simplified anastomosis for full face transplant procedure that, in turn, can potentially shorten the operative time and reduce procedure-associated complications,” Dr. Rybicki concluded.

Related Links:

Brigham and Women’s Hospital



RTI ELECTRONICS AB
SuperSonic Imagine
RADCAL

Channels

MRI

view channel

Use of Breast MRI Offers Optimized Care

Magnetic resonance imaging (MRI) is being used increasingly for breast cancer screening, diagnostic assessment, treatment planning, and monitoring; however, a recent study revealed that over time, the indication for breast MRI has changed. Much of the increase was found among women with breast cancer risk factors, but there... Read more

Ultrasound

view channel
Image: Analogic Sonic Window handheld ultrasound for peripheral IV placement (Photo courtesy of Analogic).

First-of-a-Kind Ultrasound System Designed for Image-Guided Peripheral Intravenous Access and Fits in Pocket

A new, ultra-compact ultrasound device provides direct visualization of structures beneath the skin in real time to effectively guide clinicians placing peripheral intravenous (IV) lines.... Read more

Nuclear medicine

view channel
Image: Micrograph of Hodgkin lymphoma. Lymph node fine-needle aspiration (FNA) specimen. Field stain (Photo courtesy of Wikimedia Commons).

Early PET-Negative Stage I/II Hodgkin Lymphoma Patients Show Increased Risk of Early Relapse when Radiotherapy Is Not Used

Analysis of a new study indicates an increased risk of early relapse when excluding radiotherapy in early positron emission tomography (PET) scan-negative patients with stage I/II Hodgkin’s lymphoma.... Read more

General/Advanced Imaging

view channel

Secondary Light Emission Generated by Plasmonic Nanostructures May Improve Medical Imaging Technology

New clues into light emission at different wavelengths generated by elements known plasmonic nanostructures may help to improve medical imaging technology. A plasmon is a quantum of plasma oscillation. The plasmon is a quasiparticle resulting from the quantization of plasma oscillations just as photons, and phonons are... Read more

Imaging IT

view channel

Enterprise Image-Viewing System Receives FDA Clearance for Mobile Diagnosis on All Modalities

An enterprise image-viewing system is now cleared in the United States for diagnosis on mobile devices, for all imaging modalities (except mammography). Calgary Scientific, Inc. (Calgary, AB, USA) recently reported their latest Class II clearance from the US Food and Drug Administration (FDA). Calgary Scientific worked... Read more

Industry News

view channel

Collaboration Expands Capacity for Proton Therapy Clinical Research and Patient Treatments

Varian Medical Systems (Palo Alto, CA, USA) and the Paul Scherrer Institute (PSI; Villigen PSI, Switzerland) are extending an existing collaboration in the field of proton therapy to offer patients more accurate cancer treatments using intensity-modulated proton therapy (IMPT). Under the agreement, Varian will also... Read more
 
Copyright © 2000-2014 Globetech Media. All rights reserved.