Improvement of the Inferior Epigastric Artery Flap Viability Using Adenovirus-mediated VEGF and COMP-angiopoietin-1.

Yoo, Eun Kyung; Son, Daegu; Kim, Hyung Tae; Lee, In Kyu; Choi, Taehyun; Kim, Junhyung; Han, Kihwan

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(1):1-10.
Published online January 1, 2009.

Improvement of the Inferior Epigastric Artery Flap Viability Using Adenovirus-mediated VEGF and COMP-angiopoietin-1.

Eun Kyung Yoo, Daegu Son, Hyung Tae Kim, In Kyu Lee, Taehyun Choi, Junhyung Kim, Kihwan Han

¹Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Korea. handson@dsmc.or.kr
²Department of General Surgery, Keimyung University School of Medicine, Daegu, Korea.
³Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Abstract

PURPOSE
Partial necrosis of skin flaps remains a substantial problem in reconstructive surgery. We investigated the potential use of an adenovirus vector encoding the VEGF, COMP-angiopoietin-1 gene in an attempt to promote the viability of the inferior epigastric artery flap in a rat model. METHODS: Three by six cm lower abdominal transverse skin flaps, supplied only by the left inferior epigastric artery, were designed. After skin flap elevation, the adenovirus VEGF and adenovirus COMP-angiopoietin-1 were injected into the distal portion of the flap, which has a high tendency of developing flap ischemia. Control animals were injected with the same volume of normal saline. On 3, 7 and 14 days after the flap elevation, the flap survival and vascularization were assessed using Visitrak digital(R), CD31 immunohistochemistry in addition to evaluating the general histological characteristics.
RESULTS
There was a significant increase in the mean percentage of flap viability by 89.8%, 91.1% and 94.8% in flaps transfected with adenovirus VEGF, COMP- angiopoietin-1, coadministraion of VEGF and COMP- angiopoietin-1 at seven days, and by 95.6%, 94.8% and 96.3% at 14 days. Histological assessment revealed that there were more blood vessels formed after adenovirus with VEGF, COMP-angiopoietin-1 or VEGF plus COMP- angiopoietin-1 than with adenovirus Lac Z.
CONCLUSION
The results of this study suggest that adenovirus-mediated VEGF, COMP-angiopoietin-1 gene therapy, promote therapeutic angiogenesis in patients that undergo reconstructive procedures. Key Words:

Keywords: VEGF; Angiopoietin; Gene therapy; Flap