Utilization of microvascular couplers in salvage arterial anastomosis in head and neck free flap surgery: Case series and literature review

• Published in: Head & neck Vol. 42; no. 8; pp. E1 - E7
• Main Authors: Li, Michael M., Tamaki, Akina, Seim, Nolan B., Kang, Stephen Y., Ozer, Enver, Agrawal, Amit, Old, Matthew O.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.08.2020; Wiley Subscription Services, Inc
• Subjects: Anastomosis; Anastomosis, Surgical; free flap reconstruction; Free Tissue Flaps; Head & neck cancer; Head and Neck Neoplasms - surgery; Humans; Literature reviews; Microsurgery; microvascular anastomosis; Microvasculature; Reconstructive Surgical Procedures; Retrospective Studies; Surgery; Thrombosis; Vascular Surgical Procedures; vessel couplers; free flap reconstruction; microvascular anastomosis; thrombosis; vessel couplers
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.26139

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.