Definitive Vascular Repair

SOC → SCF-DBI Logic Translation

Purpose

Definitive Vascular Repair is the surgical restoration of permanent vascular continuity following traumatic, iatrogenic, or ischemic vascular injury after physiologic stabilization has been achieved.

It represents the transition from temporary perfusion preservation (e.g., vascular shunting) to durable restoration of arterial and/or venous function.

SOC Definition

Clinical Objective

Restore long-term vascular integrity by:

• Re-establishing arterial flow
• Re-establishing venous drainage
• Preserving tissue viability
• Preventing thrombosis
• Preventing ischemia-reperfusion injury
• Maintaining limb or organ function

Common Techniques

Primary Repair

Direct vessel reconstruction via:

• End-to-end anastomosis
• Lateral repair
• Patch angioplasty

Interposition Grafting

When direct repair is not feasible:

• Autologous vein graft
• Prosthetic graft
• Biological conduit

Complex Reconstruction

May involve:

• Branch reconstruction
• Hybrid open/endovascular repair
• Multi-vessel reconstruction

SCF-DBI Translation

Core Concept

SOC views Definitive Vascular Repair as:

Restoration of blood vessel continuity.

SCF-DBI views Definitive Vascular Repair as:

Reconstruction of a Functional Perfusion Ecosystem.

The objective is not simply restoration of flow.

The objective is restoration of:

1. Perfusion continuity
2. Endothelial functionality
3. Hemodynamic stability
4. Tissue regenerative potential
5. Long-term vascular resilience

SCF-DBI Vascular Reconstruction Architecture

Domain 1

Perfusion Network Reconstruction

SOC Focus

Restore blood flow.

SCF-DBI Focus

Reconstruct Regional Perfusion Architecture.

Reconstruction Targets

Output

Perfusion Reconstruction Score (PRS-VR)

Domain 2

Graft Integration Intelligence

Major SCF-DBI Enhancement

Selected Enhancement:

Add Graft Integration Intelligence

SOC typically evaluates:

• Patency
• Flow
• Technical success

SCF-DBI evaluates:

Biological Integration of the Reconstruction

because successful implantation does not guarantee successful incorporation.

Graft Integration Domains

Integration States

Output

Graft Integration Score (GIS)

Domain 3

Thrombosis-Risk Prediction Engine

Major SCF-DBI Enhancement

Selected Enhancement:

Add Thrombosis-Risk Prediction Engine

Traditional surveillance often detects thrombosis after flow compromise develops.

SCF-DBI seeks prediction before failure occurs.

Thrombosis Risk Drivers

Hemodynamic Factors

• Low flow states
• Turbulence
• Anastomotic narrowing
• Competitive flow

Endothelial Factors

• Endothelial injury
• Glycocalyx disruption
• Persistent inflammation

Systemic Factors

• Hypercoagulability
• Massive transfusion history
• Infection
• Immobility

Surveillance Parameters

Risk Categories

Output

Thrombosis Risk Index (TRI)

Domain 4

Endothelial Recovery Surveillance

SOC

Assess graft patency.

SCF-DBI

Assess endothelial resilience.

Endothelial Recovery Domains

Output

Endothelial Recovery Score (ERS)

Domain 5

Tissue Reperfusion Intelligence

SOC

Confirm distal pulses.

SCF-DBI

Evaluate functional tissue recovery.

Assessment Domains

Output

Tissue Reperfusion Recovery Score (TRRS)

Domain 6

Anastomotic Resilience Analysis

SCF-DBI Enhancement

Beyond technical success, evaluate long-term anastomotic durability.

Assessment Domains

Output

Anastomotic Resilience Score (ARS)

Domain 7

Limb/Organ Functional Recovery Mapping

SCF-DBI Enhancement

Ultimate success is measured by restored function.

Assessment Domains

Output

Functional Recovery Preservation Map (FRPM)

RHENOVA Integration

R1 — Survival Preservation

Restore:

• Flow continuity
• Organ viability
• Tissue oxygenation

Output:

Vascular Rescue Status

R2 — Recovery Optimization

Reduce:

• Ischemic burden
• Endothelial injury
• Reperfusion stress

Output:

Recovery Readiness Score

R3 — Regenerative Integration

Promote:

• Endothelialization
• Microvascular adaptation
• Tissue regeneration

Output:

Graft Integration Profile

R4 — Durable Reconstruction

Achieve:

• Long-term patency
• Functional perfusion
• Structural stability

Output:

Reconstruction Durability Matrix

R5 — Long-Term Resilience

Prevent:

• Thrombosis
• Stenosis
• Graft failure
• Chronic ischemia

Output:

Vascular Resilience Index

SCF-DBI Definitive Vascular Repair Workflow

Step 1

Confirm physiologic readiness for reconstruction.

Output

Reconstruction Eligibility Score

Step 2

Perform definitive vascular repair.

Output

Technical Reconstruction Confirmation

Step 3

Assess perfusion restoration.

Output

Perfusion Reconstruction Score

Step 4

Evaluate graft integration.

Output

Graft Integration Score (GIS)

Step 5

Activate Thrombosis-Risk Prediction Engine.

Output

Thrombosis Risk Index (TRI)

Step 6

Assess endothelial recovery.

Output

Endothelial Recovery Score (ERS)

Step 7

Evaluate tissue reperfusion recovery.

Output

Tissue Reperfusion Recovery Score (TRRS)

Step 8

Assess anastomotic resilience.

Output

Anastomotic Resilience Score (ARS)

Step 9

Map functional recovery potential.

Output

Functional Recovery Preservation Map (FRPM)

Glossary

SCF Principle Alignment

INDEX

SCF-SURG-DEFINITIVE-VASCULAR-REPAIR-0001

SCF-DBI-GRAFT-INTEGRATION-INTELLIGENCE-0001

SCF-DBI-THROMBOSIS-RISK-PREDICTION-ENGINE-0001

SCF-DBI-ENDOTHELIAL-RECOVERY-SURVEILLANCE-0001

SCF-DBI-ANASTOMOTIC-RESILIENCE-ANALYSIS-0001

SCF-DBI-FUNCTIONAL-RECOVERY-PRESERVATION-MAP-0001

SCF-VASCULAR-RECONSTRUCTION-WORKFLOW-0015

SCF-DEFINITIVE-VASCULAR-REPAIR-MASTER-0001