End-to-side venous anastomosis with the internal jugular vein stump: a preliminary report.
BACKGROUND
Failure of free flaps is frequently because of failure of the venous vascular anastomosis. A new venous anastomosis technique that uses the stump of the internal jugular vein (IJV) is described, with preliminary data on operative outcomes.


METHODS
Retrospective analysis of eight head and neck free flap operations in which a venous anastomosis to the stump of an IJV was used compared with 222 other free flap operations in the same period (1995-2001) at a single institution.


RESULTS
None of the eight free flaps that used venous end-to-side anastomoses to the stump of an IJV failed. There were 15 failures associated with the other 222 venous microvascular anastomoses (6.8%).


CONCLUSIONS
This new technique resulted in no failures in eight operations. Advantages of this technique include avoiding creating an anastomosis under tension or requiring a saphenous vein graft and reducing pedicle torsion at the hilum of the flap.
Graham
Brian B
BB
Harvard Medical School, Boston, Massachusetts, USA.
Varvares
Mark A
MA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D002277:Carcinoma / Q000601:surgery; D002648:Child; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D007601:Jugular Veins / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D037981:Neck Dissection; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome