Three end-to-end techniques for microvascular anastomosis of vessels with different size discrepancy

BACKGROUND: Size discrepancy in microvascular anastomosis is a common issue in free flap transfer and replantation surgery. A number of different techniques have been described to overcome the problem, but optimal method continues to be defined. METHODS: Since June 2015 to May 2018, clinical courses of 103 microvascular cases performed by one senior surgeon were reviewed. Three end-to-end techniques including mechanical dilation, single-mattress suture, and wedge resection were applied in 364 anastomoses with caliber ratio between 1:1 and 1:1.5, 1:1.5 and 1:2, and 1:2 and 1: 3, respectively. RESULTS: A total of 112 flaps were incorporated in this study. The incidence of anastomotic failure was 3.0% (11/364), and the overall flap failure rate was 3.6% (4/112). The failure cases included 2 replanted scalps, 1 replanted ear, and 1 superficial temporal artery flap for nasal reconstruction. CONCLUSIONS: Our results depicted operational convenience and reliability of the 3 end-to-end anastomotic techniques in addressing mild-to-large vessel discrepancy.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Series of 364 anastomoses using mechanical dilation, single-mattress suture, or wedge resection for varying caliber ratios. 3.0% anastomotic failure, 3.6% flap failure rates across 112 flaps.

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