Mihai Ionac

Victor Babes University of Medicine and Pharmacy of Timisoara | UMFT · 2nd Surgery Dept., Division of Vascular Surgery and Reconstructive Microsurgery

Diabetic foot ulcer non-reimbursed treatment depends on multiple factors, including the patient’s buying behaviors. Factors affecting buying behaviors for the removable off-loading devices are not completely understood. The aim of this study was to investigate the patients’ buying behaviors of the removable off-loading devices and their influence o...

Purpose: With the onset of the COVID 19 pandemic, digitalization came to the forefront of education delivery and continuous professional development took place predominantly online. We investigate the relevance of e-Learning in the vascular surgery community in mainland People’s Republic of China (PRC) and address the regional variability in compar...

b> Introduction: With the steady rise in interest in e-learning and the sudden boost provoked by the COVID-19 pandemic, it becomes necessary to explore the e-learning experience within the medical community in the MENA region. Methods: An online survey was conducted during the early phase of the COVID-19 pandemic (June 15 – October 15, 2020). Resul...

Portable, custom-made electronic dynamometry for the foot and ankle is a promising assessment method that enables foot and ankle muscle function to be established in healthy participants and those affected by chronic conditions. Diabetic peripheral neuropathy (DPN) can alter foot and ankle muscle function. This study assessed ankle toque in partici...

Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared the acute effects of one day of prolonged sitting and one day of low-t...

The results of the Greek vascular society from the vascular e-Learning during the COVID-19 pandemic (EL-COVID) survey: a comparison to the global results Athens, Greece

Background Perforator flaps account for a fraction of reconstructive procedures despite their growing popularity. Specific microsurgical skills are required for successful harvesting of perforator flaps, which are difficult to attain through direct operating room training. Cadaver and small animal dissection cannot simulate human perforator dissect...

Background Buerger’s disease (BD) remains a debilitating condition. Despite multiple published diagnostic criteria for BD, none is universally accepted as a gold standard. Objective To establish consensus on the diagnostic criteria for BD. Methods We conducted a two-round modified Delphi consensus study. The questionnaire included statements from...

The negative effects of SARS-CoV-2 infection on the musculoskeletal system include symptoms of fatigue and sarcopenia. The aim of this study is to assess the impact of COVID-19 on foot muscle strength and evaluate the reproducibility of peak ankle torque measurements in time by using a custom-made electronic dynamometer. In this observational cohor...

Custom-made dynamometry was shown to objectively analyze human muscle strength around the ankle joint with accuracy, easy portability and low costs. This paper describes the full method of calibration and measurement setup and the measurement procedure when capturing ankle torque for establishing reliability of a portable custom-built electronic dy...

Custom-made dynamometry was shown to objectively analyze human muscle strength around the ankle joint with accuracy, easy portability and low costs. This paper describes the full method of calibration and measurement setup and the measurement procedure when capturing ankle torque for establishing reliability of a portable custom-built electronic dy...

Background and objectives: Regenerative medicine, with its massive development over the years, has the potential to solve some of the most problematic medical issues, such as functional organ transplantation. The aim of this study was to create a human meniscal shape 3D-printed enriched with human adipose-derived mesenchymal cells. Materials and Me...

Dataset of the Vascular e-Learning during the COVID-19 pandemic (EL-COVID) survey This dataset supports the findings of the vascular e-Learning during the COVID-19 pandemic survey (the EL-COVID survey). The General Data Protection Regulation (GDPR) of the European Union was taken into consideration in all steps of data handling. The survey was app...

Background The COrona Virus Disease (COVID-19) pandemic has radically changed the possibilities for vascular surgeons and trainees to exchange knowledge and experience. The aim of the present survey is to inventorise the e-learning needs of vascular surgeons and trainees as well as the strengths and weaknesses of vascular e-Learning. Methods An on...

This dataset supports the findings of the vascular e-Learning during the COVID-19 pandemic survey (the EL-COVID survey). The General Data Protection Regulation (GDPR) of the European Union was taken into consideration in all steps of data handling. The survey was approved by the institutional ethics committee of the Primary Investigator and an onli...

Background: Unfortunately, even today Thromboangiitis Obliterans has disease features that remain misunderstood or underappreciated. The epidemiology, etiology and pathophysiology of the disease are still unclear. Biomarkers and disease activity markers are lacking, thus clinical assessment is difficult. We are still struggling to establish unique...

(1) Background: Both open surgery and endovascular strategies are accepted methods for the treatment of critical limb ischemia (CLI) due to superficial femoral artery disease (SFA). There is currently only one randomized trial results (BASIL-1) that compared open vs. endo procedures for SFA treatment. In this study, we wanted to compare two treatme...

Aim: Here, we retrospectively analyzed the success rate of reconstructive microsurgery for tubal infertility (RMTI) as a "first-line" approach to achieving tubal reversal and pregnancy after tubal infertility. Patients and methods: During 9 consecutive years (2005-2014), 96 patients diagnosed with obstructive tubal infertility underwent RMTI (tu...

Introduction: The training to learn how to perform perforator flaps requires practice on a living model to optimize dissection and to evaluate outcome. The purpose of this study was to describe a training model that optimizes the use of animals in order to perform the maximum number of exercises per animal. Material and methods: The sequence has...

Therapeutic neoangiogenesis (TNA) holds promise as a treatment for peripheral arterial disease. Nevertheless, proper tools for in vivo pre-clinical investigation of different TNA approaches and their effects are still lacking. Here we describe a chronic ischemic hindlimb model in rats using laser Doppler quantitative evaluation of tissue perfusion....

Advanced preservation injury (PI) after intestinal transplantation has deleterious short- and long-term effects and constitutes a major research topic. Logistics and costs favor rodent studies, whereas clinical translation mandates studies in larger animals or using human material. Despite diverging reports, no direct comparison between the develop...

Purpose. Clinically apparent anastomotic leakage (AL) after low anterior rectal resection (LAR; <7 cm from anal verge) using circular double-stapled anastomosis without defunctioning stoma is up to 37.5%. However, it is unclear whether there is reduction of LAR after 21 postoperative days without defunctioning stoma but with extraluminal anastomoti...

The excess risk of amputation in the diabetic population is well documented. However, approximately half of all amputations in England are in people that do not have diabetes - the remainder being mainly peripheral arterial disease. Whilst the prevalence of foot ulcers in the population without diabetes is significantly lower than their diabetic co...

Background The composite anterolateral thigh flap with vascularized fascia lata (ALT-FL flap) for covering complex soft tissue defects involving the Achilles tendon has shown promising results. The age and body mass index (BMI) are important predictors of clinical outcome after surgical treatment of Achilles tendon ruptures. In this study, we inves...

Background: Expectations towards surgeons in modern surgical practice are extremely high with minimal complication rates and maximal patient safety as paramount objectives. Both of these aims are highly dependent on individual technical skills that require sustained, focused, and efficient training outside the clinical environment. At the same tim...

Background: Advanced microsurgical techniques have emerged as a promising approach for the treatment of lymphedema, but achieving international standards is limited by a scarcity of adequate training models. The purpose of this report is to describe our in vivo porcine training model for microsurgery. Study design: Five female common-breed pigs...

Background Clinical and experimental evidence strongly suggest that ischemia-reperfusion injury (IRI) after intestinal transplantation has deleterious short- and long-term effects and finding means to reduce IRI is a major research area. The anatomical and physiological similarities between the human and porcine digestive tract favor its use as a p...

Macrodystrophia lipomatosa is a rare, congenital, non-hereditary disease, characterized by local gigantism of the fingers or toes. We report the case of a 37-month-old boy, with no prior past medical history, who presented with a gigantic dystrophy of the left forefoot. The location of the deformity was involving the plantar and dorsal aspect of th...

Stem cells are nowadays isolated from multiple sources and used in biotechnological application. Our study presents a new method for isolation and expansion of stem cells derived from infrapatellar fat pad (IPFP) by simple adherence to plastic surface of culture flasks. This method yielded adipose-derived stromal cells (ASC) with morphological and...

BACKGROUND: Intimal hyperplasia is a multifactorial process that determines local stenosis and subsequent ischemia after revascularisation procedures. It is controlled by a plethora of cytokines, growth factors and proteases that interact through multiple mechanisms, empowering or inhibiting their hyperplasic action. Although the elements involved...

Introduction: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO(1)) systems are a life-saving option in the treatment of acute respiratory distress syndrome (ARDS(2)), but may be encumbered by severe vascular complications in the groin. Presentation of case: A pregnant woman was admitted with respiratory failure due to H1N1 influenza. V...

Tendon adhesions in zone IV after proximal phalangeal fractures are common and may lead to loss of range of motion at the proximal interphalangeal joint. The type of fracture, surgical technique and rehabilitation strategy also influence the final functional outcome. Plate fixation is a reliable solution in cases of comminuted phalangeal fracture....

Objectives: Sonoelastography is a noninvasive, real time procedure, complementary diagnostic method that increases the diagnostic qualities of conventional ductal ultrasound. We want to evaluate the added diagnostic value of sonoelastography in cases of apparent benign lesions in conventional ultrasound. Method: Prospective Study: 1115 women, under...

Purpose: The aim of the study was to evaluate the prevalence of acute kidney injury (AKI) in a cohort of surgically treated patients with peripheral artery disease (PAD) and its association with the short-term and long-term outcome. Materials and methods: We conducted a retrospective cohort study on all the consecutive PAD inpatients in 2008. Da...

With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid), and...

Unlabelled: Vascular access in haemodialysis is still accompanied by a high morbidity rate. Neointimal hyperplasia due to thrombosis is one of the main causes of vascular access failure. The purpose of this paper is to present the use of non-penetrating titanium clips (VCS) for the creation of an arteriovenous fistula and its outcome. Materials a...

Classically, infrarenal aortic exposure is achieved by xyphopubic or xypho-infraumbilical laparotomy, in transperitoneal approach, or through a left abdominal incision, in retroperitoneal approach. The transperitoneal approach is associated with longer intestinal activity resumption time and incisional hernias on long term, due to intestinal extrac...

Vascular endothelial growth factor (VEGF) is a hormone-like molecule which has been shown to act on a specific receptor system and in this way to be the basic regulator of angiogenesis. The effect on the survival of a long random skin flap was examined by exogenous administration of this cytokine, at flap's recipient site. A standard dorsal skin fl...

Vascular endothelial growth factor (VEGF) is a heparin-binding glycoprotein which plays a significant role in angiogenesis and vascular permeability. The effect of various ways of local administration of VEGF on random skin flap survival was studied, using flaps with a relatively high length (L) to width (W) ratio (5:1). An 1.5 × 7.5 cm dorsal skin...

Extrinsic chronic nerve compression induced by nonendothelium derived vascular tumors is a rare occurrence at the forearm level. We present a case of severe chronic compression of the radial sensory nerve (RSN) caused by an undiagnosed venous glomangioma. The tumor was excised with complete symptoms relief. In the presence of severe nerve compressi...

Induction of angiogenesis has been shown to be mediated by a number of glycoproteins called growth factors. Growth factors control the growth, differentiation, and metabolism of cells. Vascular endothelial growth factor (VEGF) is believed to be the most potent regulator of this process. The effect of its exogenous administration on the distal third...

Unlabelled: The present clinical trial analyzed the safety of gene therapy using plasmidial constructs expressing vascular endothelial and hepatocyte growth factors in patients with critical limb ischemia. The study included 43 patients: 29 in the treatment group and 14 allocated to the placebo group. The primary end points were the rate of major...

The authors present their experience with the use of sural fasciocutaneous flaps for the treatment of various soft tissue defects in the lower limb. This paper is a review of these flaps carried out between 2003 and 2008. The series consists of 16 patients, 11 men and 5 women with an average age of 41 years (17-81) and with a follow-up period betwe...

Background: gracilis muscle is a versatile choice for soft tissue coverage and for functional reconstruction in brachial or facial palsy and in fecal or urinary incontinence. Traditional harvest with large incisions results in increased donor-site morbidity with pejorative effect on overall outcome. Endoscopic-assisted gracilis harvest decreases th...

This study describes an experimental model of accessory renal allotransplantation in the big laboratory animal (pig). A total of 24 common-breed pigs were used. All allografts were transplanted in an accessory manner and revascularized at the level of the infrarenal abdominal aorta and inferior vena cava. The urinary drainage was performed either t...

In this study, we evaluate the feasibility of propeller flaps, for soft tissue reconstruction in patients with peripheral arterial obstructive disease (PAOD). Five patients (average age, 72 years old), presenting with necrosis of several foot units, were diagnosed with stage IV PAOD and diabetes mellitus. All underwent revascularization, followed b...

Background: gracilis muscle is a versatile choice for soft tissue coverage and for functional reconstruction in brachial or facial palsy and in fecal or urinary incontinence. Traditional harvest with large incisions results in increased donor-site morbidity with pejorative effect on overall outcome. Endoscopic-assisted gracilis harvest decreases th...

Introduction: The latissimus dorsi (LD) muscle is the workhorse for soft-tissue coverage, augmentation and functional reconstruction. Traditional harvest requires large incisions, inducing patients' dissatisfaction and downgrading the reconstruction result. Endoscopic-assisted LD harvest decreases the scar length, reduces postoperative pain, allows...

Objective: To analyze the ethiopathogeny, microbial features, therapeutic approach and the outcome of the patients with cerebral abscesses before and after standardised antibioprophylaxis. Material and methods: We studied 29 patients with cerebral abscesses that were admitted in the neurosurgery department of The Clinical Emergency County Hospital...

Objective: C- reactive protein (CRP), acute phase reactant and independent marker of inflammation in atherosclerosis, was observed pre and post-vascular surgery at patients with peripheral arterial disease (PAD). We searched for the possible influence of electroacupuncture (EA) therapy on postoperative CRP levels. Material and methods: Fifty consec...

Unlabelled: Possible hemodynamic effects of electro acupuncture (A), by two electro stimulation techniques, were studied at patients with femuro - popliteal bypass revascularization. MMATERIAL AND METHOD:In a prospective study, we evaluated two EA techniques, by calculating the ankle-brachial index (ABI) and by estimating the pain with Numeric Rat...

NOTES (Natural Orifice Translumenal Endoscopic Surgery) represents a very new acquisition in the field of gastrointestinal endoscopy, which uses common flexible endoscopes in order to perform intraperitoneal surgical procedures. This procedure offers a very good visualisation of the peritoneal cavity, as well as the possibility of performing surgic...

Endoscopic internal mammary artery (IMA) approach represents a well-established procedure in coronary bypass surgery. However, such techniques require highly trained skills that need to be mastered in experimental models before taken into the clinic. To attain such skills, our aim was to develop a training model of thoracoscopic approach for harves...

Blood oxygenation devices are an essential component of any cardiopulomonary bypass circuit in various species of laboratory animals. When using larger animals like dogs or pigs, the human and pediatric blood oxygenators could be easily used, but the disadvantage of these species is the scarcity of biochemical and genetic assays for experimental fo...

Because of their generous dimensions, constant anatomy, great plasticity and well defined vascularization, muscles remain the preferred choice when approaching reconstruction of complex tissue defects resulting after trauma or oncological resections. The latissimus dorsi, represents a widely used flap when performing reconstructive microsurgery usi...

Diabetes is chronic disease that is accompanied by a rapid thymus involution. To investigate the factors responsible for thymic involution in a model of STZ-induced diabetes, mice were injected with STZ alone or in combination with the cyclooxygenase 2 inhibitor indomethacin (INDO). Thymus weight, glycemia and serum corticosterone were measured, an...

The aim of this study was to develop an experimental model of pancreas transplantation in rats as a standardized tool for research in transplant immunobiology. Brown Norway (donors) and Lewis (receptors) rats, males, with an average weight of 220 grams, were used. The diabetes was induced in recipients using streptozocin. The pancreas was harvested...

The objectives were to evaluate the intraoperative aspects of the repairing by laparoscopy of a parcel duodenal defect, using a pediculated jejunal patch and to emphasize the intraoperative complications. The research has been made on 6 pigs. The pediculated jejunal patch was been achieved by excluding from the intestinal tract of a 2-4 cm segment...

Recent technical development has led to remarkable performances in video-guided surgical procedures. A video-endoscopic system (VES) is evaluated as an alternative magnifying solution for microsurgical procedures and compared to table-top microscopes in terms of technical and surgical aspects. Six surgical residents without microsurgical experience...

Major experimental surgery on laboratory animals requires adequate anesthesia and ventilation to keep the animal alive throughout the procedure. A ventilator is a machine that helps the anesthesized animal breathe through an endotracheal tube by pumping a volume of gas (oxygen, air, or other gaseous mixtures), comparable with the normal tidal volum...

Large duodenal defects are difficult to repair, due to complex duodenal anatomy. Musculo-epithelial flaps are conventionally used for reconstruction of large soft tissue defects. We report the experimental use of pediculate intestinal patch for repair of duodenal defects. Twelve dogs with duodenal defect underwent repair using pediculate jejunal pa...