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PubMed1997

Formation of the branching pattern of blood vessels in the wall of the avian yolk sac studied by a computer simulation.

The present study was performed to provide data to support the notion previously believed but not proved experimentally or theoretically, that blood vessels are formed by the selection of capillaries in the network. In an attempt to understand the mechanism of formation of blood vessel branching structures, the transformation of a capillary network to a branching system in the wall of quail yolk sac was successively recorded by a series of photographs, and a computer simulation was carried out for the process of in vivo vascularization based on the photographs. The simulation demonstrated that a positive feedback system participated in the formation of a branching structure. That is, vessels which had been much used were enlarged, whereas less used vessels were reduced in their size and finally extinguished. The enlarged vessels became major components of the branching system. As the body of an embryo grew, it was observed that polygonal capillary networks enlarged, which led each polygon of the network to divide into a few finer polygons. Then, some of the capillary vessels were again selected and formed a branching system. This process repeated during the body growth, indicating that the vascular system developed adaptively to the body growth. A region where the growth was fast, received much blood flow and produced finer networks of capillaries. Thus, it was experimentally demonstrated for the first time that capillaries in the network are successively selected by a positive feedback mechanism and form blood vessels.

Animals↗
PubMed2004

A comparison of manual and automated methods of measuring conjunctival vessel widths from photographic and digital images.

We investigated the application of a fully automated computer algorithm for identifying vessels of the conjunctiva from their scleral surround, and compared measures of vessel width with established methods. Vessel widths at 101 locations (ranging from 20 to 140 microm), from 12 patients, were measured from film and digital images, using a variety of methods, and compared. Widths were measured manually, by semi-automated methods using grey level (densitometric) profiles taken from digital images, and by automated techniques set at different operating levels. Good intra-session repeatibility was obtained using the automated method with an operating sigma value of 3 pixels (16 microm) (mean difference 0.5 microm, 95% CI -8.5 to 9.4 microm) and manual calliper measurements from digitally created photographic slides (mean difference 0.4 microm, -9.3 to 10.1 microm). For comparison with other measures of width, the latter was used as the gold standard. Widths measured from film were slightly larger than those measured directly from digital images, although this effect was small (5 microm) for most vessels. Overall widths measured using the automated method, with a sigma value of 3 pixels, agreed best with the gold standard (inter-method repeatibility; mean difference 1.4 microm, -32.5 to 35.2 microm) although the automated method overestimated small widths (<40 microm) and underestimated larger vessel widths (>40 microm). Automated detection of vessels of the conjunctiva from digital images avoids manual and operator involved measures which are time consuming, and which preclude large patient studies. The resulting data may help in monitoring the vascular response of the conjunctiva to surgical or pharmacological intervention, and in describing vascular changes in response to ocular or systemic disease. The application of this algorithm to the study of retinal vessels is yet to be realised.

Algorithms↗
PubMed1996

A surgical guide for identifying the lateral femoral circumflex vessels during free vascularized fibular transfer for avascular necrosis of the femoral head.

Free vascularized fibular transfer for avascular necrosis of the femoral head was developed in an attempt to preserve, rather than replace, the femoral head. In this procedure, the peroneal vessels of the autogenous fibular graft are anastomosed to recipient branches of the lateral femoral circumflex vessels. A problem with this procedure has been the difficulty in locating the lateral femoral circumflex vessels. An anatomic and surgical study was conducted to seek a consistent anatomic landmark for use in isolating these vessels. Ten cadaveric and 29 surgical hip dissections were performed. A falx, or fascial band, was consistently found approximately 10 cm distal to the anterior superior iliac spine; it is attached to the anterior intertrochanteric line of the proximal femur, with additional attachments to the investing fascia of the tensor fascia lata and rectus femoris muscles. Cautious release of this falx from superficial to deep leads to the fat layer surrounding the lateral femoral circumflex vessels. This study has shown that an anatomic landmark exists, which consistently leads to location of the lateral femoral circumflex vessels during a free vascularized fibular transfer. By incorporating the use of this landmark ito the authors' surgical technique, they have significantly reduced surgical dissection time and have provided a safe method for isolating the recipient vessels during this challenging operation.

Angiography↗
PubMed1991

Effect of intracoronary serotonin on coronary vessels in patients with stable angina and patients with variant angina.

BACKGROUND: Serotonin, a major product of platelet activation, has potent vasoactive effects in animal models, but its role in human coronary artery disease remains largely speculative. METHODS: Using quantitative coronary angiography, we compared the effects of the intracoronary infusion of graded concentrations of serotonin (10(-7) to 10(-4) mol per liter) on coronary vessels in two groups of patients with different clinical presentations of coronary disease (nine with stable angina and five with variant angina), with the effects in a control group of eight subjects with normal vessels on angiography. RESULTS: Normal coronary vessels had a biphasic response to intracoronary serotonin: dilation at concentrations up to 10(-5) mol per liter, but constriction at 10(-4) mol per liter. Vessels in patients with stable angina constricted at all concentrations, with mean (+/- SEM) maximal decreases in diameter of 23.9 +/- 3.6, 33.1 +/- 3.9, and 41.7 +/- 3.1 percent from base line in proximal, middle, and distal segments at a serotonin concentration of 10(-4) mol per liter. Smooth segments constricted more than irregular segments (42.0 +/- 4.6 vs. 21.1 +/- 1.6 percent). Four patients with stable angina had a marked reduction in collateral filling. All the patients with stable angina had angina during the intracoronary infusion of serotonin, and electrocardiographic changes were noted in six. All the patients with variant angina had angina, electrocardiographic changes, and localized occlusive epicardial coronary-artery spasm at concentrations of 10(-6) (n = 2) or 10(-5) (n = 3) mol per liter. CONCLUSIONS: Patients with stable coronary disease do not have the normal vasodilator response to intracoronary serotonin, but rather have progressive constriction, which is particularly intense in small distal and collateral vessels. Patients with variant angina have occlusive coronary-artery spasm at a dose that dilates normal vessels and causes only slight constriction in vessels from patients with stable angina. These findings suggest that serotonin, released after the intracoronary activation of platelets, may contribute to or cause myocardial ischemia in patients with coronary artery disease.

Adult↗
PubMed2002

Visualization of subsurface blood vessels by color Doppler optical coherence tomography in rats: before and after hemostatic therapy.

BACKGROUND: The ability to visualize subsurface blood vessels and measure flow may be useful in certain experimental and clinical settings. METHODS: Color Doppler optical coherence tomography was used to visualize and measure blood flow in subsurface vessels in vivo in a rat skin flap model. Local "hemostatic" interventions (epinephrine or sclerosant injection, heat probe, and laser) were then applied and imaging was repeated. The skin flap was evaluated histologically. RESULTS: Subsurface blood vessels were easily visualized in cross-section, and vessel diameter and bidirectional blood flow velocity were readily measured. Color Doppler optical coherence tomography demonstrated that flow was significantly reduced after epinephrine injection and became undetectable after the other interventions. This correlated with pathologic evidence of vessel damage in all interventions, except for epinephrine injection. Although vessel response was as predicted to most interventions, the response to epinephrine was only temporary, and limited application of heat alone from the heat probe halted flow without visually apparent surface injury. CONCLUSIONS: Color Doppler optical coherence tomography provides high-resolution, cross-sectional flow imaging in subsurface blood vessels. Color Doppler optical coherence tomography is potentially a better technique for the study of existing and new hemostatic intervention in the laboratory. Potential future clinical applications include monitoring of the response to hemostatic modalities.

Animals↗
PubMed2004

Characterization of blood vessels in bone marrow from patients with chronic myeloid leukemia and polycythemia vera.

Angiogenesis is a feature of hematological malignancies which may provide prognostic information. However, there is, as yet, no established marker for leukemia-associated vessels in bone marrow. In this study, immunohistochemical stainings for von Willebrand factor (vWf), CD34, Tie-2, angiomodulin, glycodelin, cycloxygenase-2 (Cox-2) and endoglin were compared in order to identify the bone marrow vasculature. Chronic myeloid leukemia (CML), a disease displaying intense angiogenesis, and polycythemia vera (PV), a disease with a low microvascular density (MVD), were studied, as well as normal bone marrow. Only vWf, CD34 and Tie-2 stained the bone marrow endothelium. Although more vessels were stained for vWf than for CD34, there was no evidence that vWf stained more disease-associated vessels. In double staining, Tie-2 co-localized with CD34, but vessels staining only for Tie-2 were also found. However, the number of Tie-2-positive vessels did not correlate to either the MVD or the disease. Angiomodulin, glycodelin, Cox-2 and endoglin did not stain vessel-like structures. In conclusion, estimating the MVD by means of CD34 staining appears to be the most reliable method, but none of the tested molecules qualified as a specific marker for leukemia-associated vessels in the bone marrow.

Aged↗
PubMed1960

The fine structure of some blood vessels of the earthworm, Eisenia foetida.

The fine structure of the main dorsal and ventral circulatory trunks and of the subneural vessels and capillaries of the ventral nerve cord of the earthworm, Eisenia foetida, has been studied with the electron microscope. All of these vessels are lined internally by a continuous extracellular basement membrane varying in thickness (0.03 to 1 micro) with the vessel involved. The dorsal, ventral, and subneural vessels display inside this membrane scattered flattened macrophagic or leucocytic cells called amebocytes. These lie against the inner lining of the basement membrane, covering only a small fraction of its surface. They have long, attenuated branching cell processes. All of these vessels are lined with a continuous layer of unfenestrated endothelial cells displaying myofilaments and hence qualifying for the designation of "myoendothelial cells." The degree of muscular specialization varies over a spectrum, however, ranging from a delicate endowment of thin myofilaments in the capillary myoendothelial cells to highly specialized myoendothelial cells in the main pulsating dorsal blood trunk, which serves as the worm's "heart" or propulsive "aorta." The myoendothelial cells most specialized for contraction display well organized sarcoplasmic reticulum and myofibrils with thick and thin myofilaments resembling those of the earthworm body wall musculature. In the ventral circulatory trunk, circular and longitudinal myofilaments are found in each myoendothelial cell. In the dorsal trunk, the lining myoendothelial cells contain longitudinal myofilaments. Outside these cells are circular muscle cells. The lateral parts of the dorsal vessels have an additional outer longitudinal muscle layer. The blood plasma inside all of the vessels shows scattered particles representing the circulating earthworm blood pigment, erythrocruorin.

Animals↗
PubMed2000

Optical non-invasive technique for vessel imaging: I. Experimental results.

This paper investigates some prerequisites for vessel imaging based on diffuse reflectance measurements in order to develop an optical non-invasive method for the imaging and monitoring of vessels. The method utilizes near-infrared (NIR) radiation (890 nm) from a light emitting diode. The light is guided into the tissue via an optical fibre (diameter 1.0 mm). The backscattered light is collected by an optical fibre of the same type and detected by an optical power meter. The fibres are moved over the skin in two directions with the aid of two motors operated by a microcomputer. Spatially resolved reflectance at the skin surface could be presented as a vessel-map in a colour-coded form on a computer screen. Experimental results indicate that the vessel imaging facility depends upon source-detector separation, relative position and vessel depth, and does not depend essentially on the radiant power from the light source. It is shown that, by a proper choice of probe parameters, one can improve the vessel identification ability. After vessel imaging the technique can potentially be used to monitor several physiological parameters on a selected vascular bed or to distinguish between injured and healthy tissue by monitoring local blood flow, oxygen saturation and the recirculation, pre- and post-operatively.

Arteries↗
PubMed2002

Lipids and nitric oxide in porcine retinal and choroidal blood vessels.

Lipid profiles of porcine retina, and retinal and choroidal vessels were analyzed using the gas chromatography/mass spectrometry (GC/MS) technique. The retina and both isolated retinal and choroidal vessels contained saturated fatty acid stearic acid and polyunsaturated fatty acids, including arachidonic (C20:4, AA), a precursor for vasoactive prostaglandin (PG-2) series, and W-6 docosahexaenoic acids (C22:6, DHA). However, eicosapentaenoic acid (C20:5, EPA), a precursor for PG-3 series, was not detected in these vessels. When stearic acid was used for normalization of tissue sample, the retina contained relatively higher amounts of DHA than AA, retinal vessels had equal amounts of AA and DHA, while choroidal vessels contained higher amounts of AA than DHA. We also examined the endogenous synthesis of vasoactive endothelial-derived factors like PGs and nitric oxide (NO). Since vasoactive angiotensin II (Ang II) releases these products from blood vessels, this polypeptide was used in a porcine retinal circulation model. The porcine retinal central artery was perfused with oxygenated/heparinized physiological salt solution at 37 degrees C. Changes in A1 and A2 arteriolar diameters induced by Ang II were determined in the absence and presence of the nitric oxide synthase inhibitor, l-NO Arginine (LNOA), and cyclooxygenase inhibitor, flurbiprofen (FB). The central retinal artery designated as the first order arteriole A1 and subsequent branch was defined as A2. Luminal diameters of Al and A2 arterioles were 35 +/- 2 am and 10 +/- 1 microm, respectively. Topical Ang II (10(-10) M-10(-6) M) caused small vasoconstrictions in a dose-dependent manner. This response was enhanced after inhibition of PG synthesis by (10-6 M) FB. Ang II induced-constrictions were further enhanced in the presence of NO synthase inhibitor, LNOA (10(-7) M). There was slightly more increase in Ang II-induced vasoconstrictions in the presence of both NO and PG inhibitors, suggesting that NO may cause release of PGs from these vessels. This study demonstrates that the porcine retinal arterioles have the ability to regulate vasoconstriction responses induced by Ang II by synthesis and release of endogenous vasodilating PGs and NO (especially NO); and these substances may play a vital role in porcine retinal circulation.

Angiotensin II↗
PubMed1980

Comparative effects of vasodilator drugs on large and small coronary resistance vessels in the dog.

One of the mechanisms whereby nitroglycerin is considered to reduce myocardial ischaemia and spasm is its preferential reduction of resistance of large compared with small coronary arteries. Accordingly, the action of nitroglycerin on these two resistance beds was compared with newer coronary vasodilator drugs. Following intracoronary administration of boluses of each drug, large and small vessel coronary resistance was measured in 14 dogs by recording the pressure drop across each vascular bed while flow was held constant. The dose of each drug was given to reduce small vessel resistance by 30% (range means 27 to 32%) which peaked at 5 to 10 s and declined to 8 to 18% at 1 min when reduction in large vessel resistance was at its maximum. At 1 min the large vessel resistance was decreased 56 +/- 5% by nitroglycerin, 23 +/- 5% by nitroprusside, 8 +/- 4% by perhexiline, 0 +/- 5% by verapamil and increased 8 +/- 5% by nifedipine. Nitroprusside reduced the large vessel resistance significantly less than nitroglycerin (P < 0.001) for an equivalent reduction in small vessel resistance. Perhexiline, verapamil and nifedipine did not significantly reduce large vessel resistance and the discrepancy between these results and their antianginal and antispasm effect in humans was not apparent from these experiments. However, a suitable model of coronary spasm in the dog following ergonovine injection could not be created.

Animals↗
PubMed1999

Vitamin C deficiency in guinea pigs differentially affects the expression of type IV collagen, laminin, and elastin in blood vessels.

Vitamin C deficiency causes morphologic changes in the endothelial and smooth muscle compartments of guinea pig blood vessels. Endothelial cells synthesize the basement membrane components, type IV collagen and laminin, and smooth muscle cells synthesize elastin in blood vessels. Therefore, we examined the possibility that vitamin C deficiency affects the expression of these proteins. Decreased expression of types I and II collagens in other tissues of vitamin C-deficient guinea pigs is associated with weight loss and the consequent induction of insulin-like growth factor binding proteins; thus we also used food deprivation to induce weight loss. Female guinea pigs received a vitamin C-free diet, supplemented orally with ascorbate. Vitamin C-deficient guinea pigs received the same diet but no ascorbate, and the food-deprived group received no food, but were supplemented with vitamin C. Concentrations of mRNAs for basement membrane components and elastin in blood vessels were measured by Northern blotting; overall basement membrane metabolism was assessed by measuring immunoreactive laminin and type IV 7S collagen in serum. Laminin mRNA in blood vessels and serum laminin concentrations were unaffected by vitamin C deficiency. Concentrations of type IV collagen and elastin mRNAs in blood vessels were not significantly affected in moderately scorbutic guinea pigs (0-7% weight loss), but with increased weight loss, type IV collagen mRNA was 57% (P < 0.05) and elastin mRNA was 3% (P < 0. 01) of normal values. In food-deprived guinea pigs, type IV collagen mRNA was 51% (P < 0.05) and elastin mRNA was 35% (P < 0.05) of normal. Serum type IV 7S collagen concentrations were 25% of normal in scorbutic guinea pigs with extensive weight loss. The lower expression of type IV collagen and elastin mRNAs in blood vessels may contribute to defects observed in blood vessels during scurvy.

Amino Acid Sequence↗
PubMed2005

In utero angiopoietin-2 gene delivery remodels placental blood vessel phenotype: a murine model for studying placental angiogenesis.

Angiopoietin (Ang)-2, the natural antagonist of the Ang1/Tie2 receptor is a complex regulator of blood vessel plasticity that plays a pivotal role in both vessel sprouting [in the presence of vascular endothelial growth factor (VEGF)-A] and vessel regression (in the absence of VEGF-A). Based on the spatial and temporal expression of Ang2 throughout human gestation, we recently suggested that the Ang2 may play a pivotal role in placental angiogenesis. Further, to examine this tenet we have developed a novel murine model system in which in utero Ang2 gene delivery via a non-replicating adenoviral expression vector has the potential to manipulate the blood vessel phenotype in vivo during pregnancy. Ang2 overexpression selectively and rapidly remodels the labyrinth perivascular extracellular matrix, subsequently promoting plasticity of the maternal and fetal vessels, which appear honeycombed due to a 2-fold increase in blood vessel luminal area. High levels of Ang2 impair endothelial cell adhesiveness, leading to vascular leakiness with perivascular oedema, which increases placental weight. These observations suggest that the Ang2 overexpression may play a key role in placental vascular remodelling. Furthermore, we suggest a novel new model to study the pathobiology of placental vascularization and the effect of placental blood vessels on fetal phenotype.

Angiopoietin-2↗
PubMed1995

Vasodilatory effect of nicorandil on coronary arterial microvessels: its dependency on vessel size and the involvement of the ATP-sensitive potassium channels.

We aimed to clarify the size dependency of nicorandil-induced dilation in coronary microcirculation and the involvement of adenosine triphosphate (ATP)-sensitive potassium channels. Coronary arterial microvessels were observed through a microscope equipped with a floating objective in anesthetized open-chest dogs (n = 29). Heart rate and mean aortic pressure were maintained at control level. In 16 dogs, nicorandil was infused into the coronary in a cumulative fashion (0.1, 1.0, 10, and 100 micrograms/kg/min, for 5 min for each dose). In 13 dogs, glibenclamide (10 microM) was topically applied onto the observed area, and nicorandil was similarly infused. Nicorandil dilated vessels < 100 microns in diameter at all applied doses in a dose-dependent manner. Glibenclamide abolished the dilation of these vessels at the lower two doses. Vessels > 100 microns in diameter dilated only at the two higher doses and the dilation was not affected by glibenclamide. These data suggest that the vessels < 100 microns are more sensitive to this agent than other size vessels, and that ATP-sensitive potassium channels are involved in the nicorandil-induced dilation of vessels smaller than 100 microns, whereas the dilation of other size vessels occurs independently of this channel.

Adenosine Triphosphate↗
PubMed1991

Ectatic blood vessels in port-wine stains lack innervation: possible role in pathogenesis.

The innervation pattern of port-wine stains was investigated using indirect immunohistochemistry with antibodies to protein gene product 9.5 (PGP 9.5), neuron-specific enolase (NSE), calcitonin gene-related peptide (CGRP), and neurofilament (NF). The pathologically dilated vessels in the middle and deep dermis were found to have defective innervation with only single or no nerve fibers in their vicinity, while other structures in the skin showed a normal density of fibers. NSE- and PGP-like immunoreactive (-LI) nerve fibers were observed innervating vessels with a normal morphology and other structures in the skin, such as sweat glands and hair follicles, as free nerve endings and in nerve bundles. The nerve bundles were often seen to pass the ectatic vessels without giving off any branches. CGRP-LI nerve fibers were detected running toward epidermis, whereas no fibers were found around the ectatic vessels. NF-LI fibers were seen innervating normal vessels in dermis, while in relation to the dilated vessels, no or only occasional fibers were observed. The lack of innervation may be of importance for the development of the disease as a result of decreased tonus of the vessels and/or a loss of neuronal trophic factors.

Adult↗
PubMed1995

A numeric index based on spatial frequency for the tortuosity of retinal vessels and its application to plus disease in retinopathy of prematurity.

BACKGROUND: In retinopathy of prematurity (ROP), tortuosity of vessels near the posterior pole of the fundus is an important clinical sign, yet clinicians have difficulty estimating how tortuous the vessels are. METHODS: The authors have devised an objective, numeric index of retinal blood vessel tortuosity that is especially sensitive to the structural changes in vessels that occur in ROP, but it is not particularly sensitive to non-ROP changes. Computer software is used to calculate the index from fundus images; the quality of these images is typical of photographs or video-cassette frames that the authors record in the premature nursery. RESULTS: The index reliably segregates tortuous vessels from nontortuous ones and separates eyes that reach ROP treatment threshold from eyes that do not. CONCLUSIONS: The index forms an objective measure of the ROP disease state. Its calculation requires only segments of vessels and thus, is potentially adaptable to imaging systems that automatically extract vessel portions from fundus images.

Fundus Oculi↗
PubMed1999

Absence of myocardial ischemia during sudden controlled occlusion of coronary arteries in patients with well-developed collateral vessels.

OBJECTIVE: To determine whether the presence of well-developed collateral vessels (visualized by baseline angiography) prevents myocardial ischemia associated with electrocardiographic ST-segment deviation or anginal pain during subsequent coronary balloon occlusion. METHODS: Study patients with stable effort angina but without complete coronary obstruction were divided into two groups on the basis of whether myocardial ischemia was observed during the first minute of coronary balloon occlusion in order to compare the degrees of collateral development at baseline. Patients in group A (n = 47) had electrocardiographic ischemic ST-segment deviations or angina, or both, during balloon inflation, whereas patients in group B (n = 13) had neither. RESULTS: The incidences both of poor anterograde perfusion with TIMI grade 1 or 2 (77 versus 38%, P < 0.05) and of well-developed collateral vessels (Rentrop grade 3) in the perfusion territory of the target vessel for coronary angioplasty (77 versus 15%, P < 0.01) were higher for patients in group B than they were for those in group A. The incidence of no myocardial ischemia during balloon inflation among the patients with well-developed collateral vessels was higher than that among those without (59 versus 7%, P < 0.01). The prediction of the absence of myocardial ischemia during balloon inflation according to whether well-developed collateral vessels were present had the sensitivity 77% (10 of 13) and the specificity 93% (40 of 43) for the study patients. CONCLUSION: Absence of myocardial ischemia (revealed by electrocardiographic changes or angina during transient coronary balloon occlusion) was associated with presence of well-developed collateral vessels (Rentrop grade 3; visualized by baseline angiography), suggesting that the patients with well-developed collateral vessels have a low risk of developing acute myocardial infarction or hemodynamic instability upon abrupt closure of the culprit coronary artery.

Angioplasty, Balloon, Coronary↗
PubMed2007

Avoiding neurologic complications following ligation of the segmental vessels during anterior instrumentation of the thoracolumbar spine.

STUDY DESIGN: A retrospective evaluation of anterior instrumentation of the vertebral bodies in the thoracolumbar spine. OBJECTIVE: To evaluate the possibility of preserving the segmental vessels following anterior instrumentation. SUMMARY OF BACKGROUND DATA: Occlusion of the segmental vessels, routinely performed during anterior spine instrumentation, might cause neurologic injury secondary to cord ischemia. METHODS: The medical data of 29 patients following anterior instrumentation of the vertebral bodies at the thoracolumbar spine were reviewed. All underwent surgery recently when we decided to preserve the segmental vessels whenever possible. We sought the reasons that enabled us to do so regarding age, gender, underlying pathology, surgical technique, operation duration, instrumentation type and size, and location in the vertebral body. RESULTS: In only 7 patients, fused between T10 and L5, were we able to preserve the segmental vessels. All were instrumented with one 6.25-7-mm wide screw in each vertebral body connected by one rod, approximately half the screws above and half below the segmental vessels. In 22 patients, we were unable to preserve the vessels due to the need to insert 2 screws or a large threaded wide vertebral cage into each vertebra. CONCLUSIONS: There is adequate space anteriorly in the vertebral body, above and below the segmental vessels, for the insertion of one screw, even with staples.

Adolescent↗
PubMed2004

Tumescent and dry liposuction of lower extremities: differences in lymph vessel injury.

Lipectomy is a standard procedure in plastic surgery. Until now, however, there was no definite information about the influence of different liposuction techniques (tumescent versus dry liposuction) on the integrity of lymph collectors during this procedure. To study the effect of these liposuction techniques on the incidence of lymph vessel injury, postmortem lymphatic preparations were done in nine human cadavers (18 lower extremities). Conventional liposuction with a blunt 4-mm cannula in the dry technique (n = 29 regions) was compared with the tumescent technique (n = 26). Liposuction was performed in parallel to the superficial lymph vessels (longitudinal suction) or transversally in an 80-degree to 90-degree angle to the extremity (vertical suction). Careful surgical preparation of different regions followed. A specific macroscopic lymph vessel injury score was applied to differentiate three degrees of lymph vessel lesions according to the extravasation of patent blue. In all lower extremities, postmortem lymph flow occurred as indicated by patent blue staining of the lymph vessels. Injection of fluid that is obligatory during tumescent suction did not result in grade 2 injury. On the contrary, tumescent suction overall produced significantly fewer lymph vessel lesions when compared with the dry technique (p < 0.05). Longitudinal liposuction produced significantly less injury when compared with vertical suction (p < 0.05). Tumescent suction and dry suction were equally effective in removing adipose aspirates, as verified by circumference measurements. In addition, tumescent liposuction is unlikely to cause major lesions of epifascial lymph vessels during suction procedures vertical to the extremity axis. Therefore, in this respect, this technique is superior to dry suction.

Aged↗