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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2013 Giugno;20(2):81-7
Experimental study of the blood supply in the colon’s left half to prevent ischemic complications of the resection of infrarenal abdominal aortic aneurysm
Dyussupov A. 1, Karpenko A. 2, Tshernyavsky A. 2, Rakhmetov N. 1, Dyussupov A. 1, Bulanov B. 1 ✉
1 Department of Vascular Surgery, Semey State Medical University’s Medical Center, Semey, Republic of the Kazakhstan;
2 Center of Vascular and Hybrid Surgery, Center of Aorta, Coronary and Peripheral Arteries Surgery, Novosibirsk Scientific-Research Institute of Blood Circulation Pathology by Academician, E.N. Meshalkin, Novosibirsk, Russian Federation
Aim: The aim of the study was to apply experimental study in order to investigate the role of visceral and pelvic arteries in blood supply of the colon’s left half and to determine the necessity to restore their pathway at resection of infrarenal abdominal aortic aneurysm (AAA) for prevention the development of ischemic complications.
Methods: The experimental study was carried out on 18 human corpses aged 60 years and over by terms of intra-arterial introduction of 40% solution of lead nitrate and 1% methylene blue solution injected turn by turn into the superior mesenteric artery, internal iliac artery and inferior mesenteric artery. After each injection of the experimental solution was performed, a sample of the proximal sigmoid colon’s wall was extracted, dried and examined under JSM-6390 LV JEOL electron microscope and INCA ENERGY 250 energy dispersive microanalysis system.
Results: The concentration of lead in the samples taken from the wall of the proximal sigmoid colon after injection into the superior mesenteric artery was equal to 1.01±0.28%, after injection into the internal iliac artery – 1.60±0.64% and after injection into the lower mesenteric artery – 17.27±2.68%.
Conclusion: Internal iliac arteries hold the second position after inferior mesenteric artery in the blood supply to the distal descending colon, sigmoid colon and rectum that proves the importance to restore their pathway at resection of infrarenal AAA in order to prevent ischemic complications. We developed the technique of intra-arterial injection of lead nitrate 40% solution in a mixture with methylene blue 1% solution with subsequent study of the samples by means of electron microscopy with energy dispersive microanalysis system. This allows to determine the chemical elemental composition of the samples in percentage, provides an opportunity to demonstrate objectively the involvement of arteries in the blood supply of a certain area of tissue in experimental condition on human corpses.