Pre-arterialisation of the arterialised venous flap: an experimental study in the rat.

Arteriovenous fistulae cause haemodynamic and morphological changes to the local venous channels. We have used the concept of preformed arteriovenous fistulae to study the viability improvement of arterialised venous flaps. Five groups of flaps were created using the abdominal skin of the Wistar rat (n= 10 in each group) with a silastic sheet implanted underneath. Group 1 (control) contained a flap without a vascular supply, group 2 (venous perfusion flap) contained a single pedicled skeletonised vein and a draining vein, and group 3 (arterialised venous flap) contained an arteriovenous shunt proximal to the single pedicled skeletonised vein and a draining vein; in group 4 (7 day pre-arterialised flap) the arteriovenous shunt was performed 7 days before the flap was raised in the same procedure as group 3, and in group 5 (14 day pre-arterialised flap) the arteriovenous shunt was performed 14 days before the flap was raised. The surviving surface areas of the flaps in each group, assessed 7 days after raising, were 0%, 22.21%, 54.32%, 62.21% and 97.47%, respectively. There was a statistically significant difference in survival between venous perfusion flaps and arterialised venous flaps (P= 0.05). Only the 14 day pre-arterialised flaps had a statistically significantly larger area of survival than arterialised venous flaps (P= 0.05). Microangioarchitecture of the pre-arterialised group, studied by the microvascular corrosion-cast technique combined with scanning electron microscopy and transmission electron microscopy, revealed dilatation of veins, numerous small neo-vessels and a decrease in or total absence of functioning valves. We conclude that 14-day pre-arterialisation in the rat model improved the survival of arterialised venous flaps by increasing collateral pathways for arterialised blood flow through the flap.

Cerebral microvascular architecture in the common tree shrew (Tupaia glis) revealed by plastic corrosion casts.

The vascularization of the cerebrum (cerebral cortex and basal ganglia) in the common tree shrew (Tupaia glis) has been studied in detail using vinyl injection and vascular corrosion cast/SEM techniques. It is found that the arterial supply of the cerebral cortex are from cortical branches of the middle cerebral artery (MCA) and of the anterior cerebral artery (ACA). These arteries are in turn branches of the internal carotid artery (ICA). In addition, the cerebral cortex receives the blood from the cortical branches of the posterior cerebral artery (PCA) that originates from the basilar artery (BA). These cortical arteries gives rise to rectilinear orientated intracortical arteries that are divided into dense capillary networks to supply the cerebral cortex. The capillary networks drain the blood into intracortical veins and then into the tributaries of major superficial cerebral veins. The basal ganglia (caudate and lentiform nuclei) are supplied by central or perforating branches of the ACA and MCA. These central or medullary arteries give rise to arterioles that ramify into dense capillary plexuses. The venous blood from both nuclei drains into venules and finally into the tributaries of internal cerebral veins. It is obvious that on the ventral aspect, the diameter of the lateral striate artery (LSA) and of the penetrating arterioles from the MCA are much smaller than that of the MCA. These arterioles have few side branches while the peripheral branches of the superficial cerebral arteries exhibit several series of branches that are gradually reduced in diameter before branching into intracortical arteries. This could be one of the reasons why the rupture of cerebral arteries in man mostly occurs in the those originating from the ventral surface rather than from the dorsolateral surface.

Testicular microvascularization in the common tree shrew (Tupaia glis) as revealed by vascular corrosion cast/SEM and by TEM.

Testicular angioarchitecture in lower primates has not been established and the route of androgens from Leydig cells entering the systemic circulation is still a matter of controversy. In the present study, the common tree shrew (Tupaia glis) was used as the model for vascular corrosion cast/SEM and conventional TEM studies. With vascular corrosion cast/SEM, it was revealed that while coursing in the spermatic cord, the testicular artery convoluted and gave off branches to supply the epididymis, the coverings of the spermatic cord and the pampiniform plexus. Upon approaching the testis, it encircled the organ, then penetrated into the testicular parenchyma near the rostro-medial pole before further dividing into arterioles that gave rise to capillary plexuses looping around the seminiferous tubules. These capillaries converged into the intratesticular venules, then into larger venules on ventral and dorsal surfaces of the testis and finally into the collecting veins on medial and lateral borders of the testis. In addition, the capillaries in the central or medullary portion of the gland collected the blood into the medullary venules and central (medullary) vein, respectively. The collecting veins as well as central vein joined together before dividing into pampiniform plexus. With transmission electron microscopy, the capillaries in the testis were shown to be of the thick basement membrane and continuous type. The Leydig cells were found adjacent to lymphatic vessels among the seminiferous tubules. This structure is compatible with the idea that most of the androgens drain into the lymphatic vessels rather than into the capillaries.

Angioarchitecture of the coeliac sympathetic ganglion complex in the common tree shrew (Tupaia glis).

The angioarchitecture of the coeliac sympathetic ganglion complex (CGC) of the common tree shrew (Tupaia glis) was studied by the vascular corrosion cast technique in conjunction with scanning electron microscopy. The CGC of the tree shrew was found to be a highly vascularised organ. It normally received arterial blood supply from branches of the inferior phrenic, superior suprarenal and inferior suprarenal arteries and of the abdominal aorta. In some animals, its blood supply was also derived from branches of the middle suprarenal arteries, coeliac artery, superior mesenteric artery and lumbar arteries. These arteries penetrated the ganglion at variable points and in slightly different patterns. They gave off peripheral branches to form a subcapsular capillary plexus while their main trunks traversed deeply into the inner part before branching into the densely packed intraganglionic capillary networks. The capillaries merged to form venules before draining into collecting veins at the peripheral region of the ganglion complex. Finally, the veins coursed to the dorsal aspect of the ganglion to drain into the renal and inferior phrenic veins and the inferior vena cava. The capillaries on the coeliac ganglion complex do not possess fenestrations.

Microvascularization in trigeminal ganglion of the common tree shrew (Tupaia glis).

Since there is only a limited number of studies of the blood supply to the trigeminal ganglion (TG) in mammalian species, the TG from 16 common tree shrews (Tupaia glis) were investigated by light microscope, transmission electron microscope (TEM) and the corrosion cast technique in conjunction with scanning electron microscope (SEM). It was found that the TG contained clusters of neurons in the peripheral region whereas the bundles of nerve fibers were located more centrally. Each ganglionic neuron had a concentric nucleus and was ensheathed by satellite cells. It was noted that blood vessels of a continuous type were predominantly found in the area where the neurons were densely located and were much less frequently observed in the area occupied by nerve fibers. With TEM, the TG was shown to be mainly associated with large neurons containing big nuclei and prominent nucleoli. The blood supply of the TG is derived from the most rostral branch of the pontine artery, from the stapedial artery or sometimes from the supraorbital artery, and from the accessory meningeal artery which is a branch of the maxillary artery passing through the foramen ovale. These arteries give off branches and become capillary networks in the ganglion before draining blood to the peripheral region. The veins at the medial border drained into the cavernous sinus directly or through the inferior hypophyseal vein, while those at the lateral side of the ganglion carried the blood into the pterygoid plexus via an accessory meningeal vein. The veins along the trigeminal nerve root joined the posterior part of the cavernous sinus. These studies establish a unique anatomical distribution of the TG blood supply in the tree shrew and the utility of the cast/SEM technique in discerning detailed features of the blood supply in the nervous system.