Y Polyatskaya1, N S Nelson1, J J Rodriguez1, A R Zheutlin1, S S Deshpande1, P A Felice2, A Donneys1, S R Buchman3. 1. Craniofacial Research Laboratory, Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA. 2. Department of Surgery, University of South Carolina School of Medicine, Columbia, SC, USA. 3. Craniofacial Research Laboratory, Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA. Electronic address: sbuchman@med.umich.edu.
Abstract
BACKGROUND: Although expander-based breast reconstruction is the most commonly used method of reconstruction worldwide, it continues to be plagued with complication rates as high as 60% when radiotherapy is implemented. We hypothesized that quantitative measures of radiotherapy-induced vascular injury can be mitigated by utilizing amifostine in a murine model of expander-based breast reconstruction. METHODS: 30 rats were divided into three groups: expander placement (Control), expander placement followed by radiotherapy (XRT), and expander placement followed by radiotherapy with amifostine (AMF/XRT). All groups underwent placement of a sub-latissimus tissue expander. After a 45 day recovery period, all groups underwent vascular perfusion and micro-CT analysis. RESULTS: Micro-CT analysis was used to calculate vessel volume fraction (VVF), vessel number (VN), and vessel separation (VSp). A significant increase in VN was seen in the XRT group as compared to the Control (p = 0.021) and the AMF/XRT (p = 0.027). There was no difference between Control and AMF/XRT (p = 0.862). VVF was significantly higher in XRT than either Control (p = 0.043) and AMF/XRT (p = 0.040), however no difference was seen between Control and AMF/XRT (p = 0.980). VSp of XRT was smaller when compared to both Control and AMF/XRT specimens (p = 0.05 and p = 0.048, respectively), and no difference was seen between Control and AMF/XRT (p = 0.339). CONCLUSIONS: Amifostine administered prior to radiotherapy preserved vascular metrics similar to those of non-radiated specimens. Elevated vascularity demonstrated within the XRT group was not seen in either the Control or AMF/XRT groups. These results indicate that amifostine protects soft tissue in our model from a radiotherapy-induced pathologic vascular response.
BACKGROUND: Although expander-based breast reconstruction is the most commonly used method of reconstruction worldwide, it continues to be plagued with complication rates as high as 60% when radiotherapy is implemented. We hypothesized that quantitative measures of radiotherapy-induced vascular injury can be mitigated by utilizing amifostine in a murine model of expander-based breast reconstruction. METHODS: 30 rats were divided into three groups: expander placement (Control), expander placement followed by radiotherapy (XRT), and expander placement followed by radiotherapy with amifostine (AMF/XRT). All groups underwent placement of a sub-latissimus tissue expander. After a 45 day recovery period, all groups underwent vascular perfusion and micro-CT analysis. RESULTS: Micro-CT analysis was used to calculate vessel volume fraction (VVF), vessel number (VN), and vessel separation (VSp). A significant increase in VN was seen in the XRT group as compared to the Control (p = 0.021) and the AMF/XRT (p = 0.027). There was no difference between Control and AMF/XRT (p = 0.862). VVF was significantly higher in XRT than either Control (p = 0.043) and AMF/XRT (p = 0.040), however no difference was seen between Control and AMF/XRT (p = 0.980). VSp of XRT was smaller when compared to both Control and AMF/XRT specimens (p = 0.05 and p = 0.048, respectively), and no difference was seen between Control and AMF/XRT (p = 0.339). CONCLUSIONS:Amifostine administered prior to radiotherapy preserved vascular metrics similar to those of non-radiated specimens. Elevated vascularity demonstrated within the XRT group was not seen in either the Control or AMF/XRT groups. These results indicate that amifostine protects soft tissue in our model from a radiotherapy-induced pathologic vascular response.
Authors: Alicia E Snider; Jeremy V Lynn; Kevin M Urlaub; Alexis Donneys; Yekaterina Polyatskaya; Noah S Nelson; Russell E Ettinger; Geoffrey C Gurtner; Mark M Banaszak Holl; Steven R Buchman Journal: Ann Plast Surg Date: 2018-11 Impact factor: 1.539
Authors: Jeremy V Lynn; Kevin M Urlaub; Kavitha Ranganathan; Alexis Donneys; Noah S Nelson; Chitra Subramanian; Mark S Cohen; Steven R Buchman Journal: Plast Reconstr Surg Date: 2019-06 Impact factor: 4.730
Authors: Kavitha Ranganathan; Eric Simon; Jeremy Lynn; Alicia Snider; Yu Zhang; Noah Nelson; Alexis Donneys; Jose Rodriguez; Lauren Buchman; Dawn Reyna; Elke Lipka; Steven R Buchman Journal: Pharm Res Date: 2018-03-19 Impact factor: 4.200
Authors: Alexandra O Luby; Chitra Subramanian; Lauren K Buchman; Jeremy V Lynn; Kevin M Urlaub; Noah S Nelson; Alexis Donneys; Mark S Cohen; Steven R Buchman Journal: Ann Plast Surg Date: 2020-10 Impact factor: 1.763
Authors: Alexandra O Luby; Alicia E Snider; Gurjit S Mandair; Kevin M Urlaub; Jeremy V Lynn; Noah S Nelson; Alexis Donneys; Russell E Ettinger; Geoffrey C Gurtner; David Kohn; Steven R Buchman Journal: Ann Plast Surg Date: 2020-11 Impact factor: 1.763