Using an unconventional perfusion pattern in ear replantation-arterialization of the venous system
Momeni A, Parrett BM, Kuri M (2014) · Microsurgery · n=1
RCT evidence detailTrial reference
Study Profile
- Design
- single-patient case report (25-year-old male, human bite injury, Stanford University Medical Center)
- Sample size (n)
- 1
- Intervention
- Subtotal ear replantation with end-to-end arterio-venous anastomosis (arterialization of venous system) without vein grafts; postoperative leech therapy for venous drainage
- Comparator
- Conventional arterial-venous anastomotic patterns
- Primary endpoint
- Ear survival with non-conventional perfusion pattern
- Primary result
- Successful ear survival with arterialization of venous system; postoperative leech therapy provided venous drainage; discharged after 14 days; reportedly first case of subtotal ear amputation successfully replanted by arterialization of venous system
- Follow-up duration
- Postoperative discharge at 14 days
- PMID
- 25116223
Key Findings
- First reported successful ear replant via venous system arterialization
- End-to-end arterio-venous anastomosis without vein grafts
- Postoperative leech therapy enabled unconventional perfusion
- 14-day hospitalization to discharge
- Preserves superficial temporal vessels for future use
Limitations
- Single case - hypothesis-generating only
- Cannot generalize unconventional approach
- Limited long-term aesthetic data
- Patient selection criteria for venous arterialization unclear
- Human bite mechanism may limit comparison to other amputations
Clinical Implications
Momeni 2014 demonstrates how reliable leech-mediated venous drainage support enables surgical innovation - specifically, unconventional venous system arterialization in ear replantation. For US clinicians under K040187, this case illustrates the device's enabling role for technical innovation in challenging anatomic scenarios where conventional vein grafting is not feasible.
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