Utilization of microvascular couplers in salvage arterial anastomosis in head and neck free flap surgery: Case series and literature review. Issue 8 (20th March 2020)

• Record Type: Journal Article
• Authors: Li, Michael M.; Tamaki, Akina; Seim, Nolan B.; Kang, Stephen Y.; Ozer, Enver; Agrawal, Amit; Old, Matthew O.
• Is Part Of: Head & neck. Volume 42:Issue 8(2020)
• Page Start: E1
• Page End: E7
• Publication Date: 2020-03-20
• Subjects: free flap reconstruction -- microvascular anastomosis -- thrombosis -- vessel couplers; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26139
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: In microvascular reconstruction of ablative oncologic defects, coupler devices have traditionally been used for venous anastomosis, whereas the arterial anastomosis is hand‐sewn. In the setting of repeated intraoperative arterial anastomotic thrombosis, a coupler device may be of use in reducing the risk of rethrombosis. Methods: Two patients were seen with advanced stage head and neck cancer and underwent oncologic resection. During microvascular reconstruction, a clot at the arterial anastomosis was encountered in both cases. Results: After starting therapeutic anticoagulation and attempting unsuccessful suture reanastomosis, coupler devices were used for arterial anastomosis, resulting in viable free‐tissue transfer. Conclusions: Although traditionally used for venous anastomosis, coupler devices may serve a purpose in the salvage setting when facing repeated intraoperative arterial thrombosis.