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The pruitt‐inahara carotid shunt as an assisting tool to anastomose the arterial free flap pedicle to the internal carotid artery in the vessel‐depleted neck
Author(s) -
Salgarello Marzia,
Snider Francesco,
Finocchi Valerio,
Bussu Francesco,
Paludetti Gaetano,
Almadori Giovanni
Publication year - 2011
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20849
Subject(s) - medicine , anastomosis , external carotid artery , free flap , internal carotid artery , surgery , internal jugular vein , shunt (medical) , common carotid artery , artery , microsurgery , carotid arteries , radiology , anatomy
Microvascular free tissue transfer in head and neck reconstruction requires suitable recipient vessels which are frequently compromised by prior surgery or radiotherapy to the neck. This article details a new technique of arterial free flap pedicle anastomosis to the internal carotid artery in a vessel‐depleted neck. A 63‐year‐old female was referred because of recurrence of squamous cell carcinoma of the tongue, which involved the left‐sided tongue base and pharynx with circumferential involvement of the homolateral external carotid artery. This artery and its branches were excluded as potential recipients. To close the defect after tumor excision, a free vertical rectus abdominis muscle arterial flap pedicle was anastomosed to the homolateral internal carotid artery with the help of a Pruitt‐Inahara outlying carotid shunt. The venous anastomosis was performed to the internal jugular vein. The VRAM flap survived without complications. This procedure is to be considered an alternative rescue technique for salvage reconstruction in vessel depleted necks. © 2011 Wiley‐Liss, Inc. Microsurgery, 2011.