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Utilization of microvascular couplers in salvage arterial anastomosis in head and neck free flap surgery: Case series and literature review
Author(s) -
Li Michael M.,
Tamaki Akina,
Seim Nolan B.,
Kang Stephen Y.,
Ozer Enver,
Agrawal Amit,
Old Matthew O.
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26139
Subject(s) - medicine , anastomosis , surgery , thrombosis , fibrous joint , free flap , microsurgery , head and neck , head and neck cancer , radiation therapy
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.