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Thoracoacromial vessels as recipients for head and neck reconstruction and cause of vascular complications
Author(s) -
Onoda Satoshi,
Sakuraba Minoru,
Asano Takayuki,
Miyamoto Shimpei,
Hayashi Ryuichi,
Asai Masao,
Kimata Yoshihiro
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.20947
Subject(s) - medicine , surgery , microsurgery , anastomosis , thrombosis , free flap , dissection (medical) , head and neck , venous thrombosis , neck dissection , radiology , cancer
Background: The choice of recipient vessels is an important factor for successful head and neck reconstruction. Finding good recipient vessels for neck microsurgery can be difficult after patients have undergone radiation therapy, previous neck dissection or developed neck infections due to pharyngocutaneous fistulae. Thoracoacromial arteries and veins can be good alternatives to common recipient vessels in such patients. We reviewed the complications, advantages and disadvantages associated with using thoracoacromial arteries and veins as recipient vessels. Methods: We reviewed eight patients whose thoracoacromial arteries and veins served as recipient vessels for head and neck reconstruction between 2002 and 2009. Preoperative status, reconstruction method and operative outcomes with complications were evaluated. Results: Postoperative complications related to microsurgical anastomosis developed in two of the eight patients. One arterial and venous thrombosis developed in each patient. We considered that the arterial thrombosis was derived from a technical problem with the operation and the venous thrombosis was derived from postoperative external pressure. Conclusions: Thoracoacromial arteries and veins are good recipient vessels for patients who have undergone ablative or reconstructive surgery, radiation therapy, or have a neck infection due to complications. However, we believe that using these vessels as recipients requires specific precautions that differ from those associated with general head and neck reconstruction. © 2011 Wiley Periodicals, Inc. Microsurgery, 2011