Document Detail

1000 consecutive venous anastomoses using the microvascular anastomotic coupler in breast reconstruction.
MedLine Citation:
PMID:  20195107     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Microvascular anastomosis is one of the more critical aspects of free flap surgery. A safe, effective, and expedient method for venous anastomosis minimizes flap ischemia time, is easier on the surgical team, and saves costly operating room time. The authors report on their experience using the Synovis microvascular anastomotic coupling device in 1000 consecutive venous anastomoses in free flap breast reconstruction.
METHODS: The authors retrospectively reviewed 1000 consecutive venous anastomoses that were performed using the microvascular anastomotic coupler between July of 2002 and July of 2008. Data were obtained on flap type, recipient vessel, coupler size, incidence of venous thrombosis, timing of venous thrombosis, and morbidity as a result of venous thrombosis.
RESULTS: All anastomoses were performed in an end-to-end fashion. There were 460 unilateral cases and 270 bilateral cases of breast reconstruction. Flap types included muscle-sparing free transverse rectus abdominis myocutaneous, deep inferior epigastric perforator, superficial inferior epigastric artery, superior gluteal artery perforator, and inferior gluteal artery perforator. The vast majority of the recipient vessels were the internal mammary or thoracodorsal vessels. Most of the couplers that were used were either 3 or 2.5 mm in diameter. Overall, there were six instances of venous thrombosis (rate of 0.6 percent). There were no total flap losses due to venous thrombosis in this series, although two patients had partial flap necrosis.
CONCLUSIONS: The patency rate for venous anastomoses performed with the microvascular coupler is excellent when compared with standard suture techniques and has the advantage of overall easier application.
Shareef Jandali; Liza C Wu; Stephen J Vega; Stephen J Kovach; Joseph M Serletti
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  125     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-02     Completed Date:  2010-04-13     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  792-8     Citation Subset:  AIM; IM    
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MeSH Terms
Anastomosis, Surgical / instrumentation
Equipment Design
Intraoperative Complications / epidemiology
Mammaplasty / instrumentation*,  methods
Microsurgery / instrumentation
Retrospective Studies
Surgical Flaps
Vascular Patency
Venous Thrombosis / epidemiology
Comment In:
Plast Reconstr Surg. 2010 Nov;126(5):1789; author reply 1789   [PMID:  21042147 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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