title: Versatility of a posterior-wall-first anastomotic technique using a short-thread double-needle microsuture for atherosclerotic arterial anastomosis.
abstract: To perform safe anastomosis for atherosclerotic arteries, we employed a posterior-wall-first anastomotic technique with a short-thread double-needle microsuture. Between October 2005 and September 2007, we performed 17 free flap transfers to the head and neck regions with this technique. Fifteen of 17 patients had one or more risk factors for atherosclerosis. In all patients except one, the superior thyroid artery was employed as a recipient artery and end-to-end anastomosis was performed close to its origin with the external carotid artery. Postoperatively, no anastomotic thrombosis occurred in any patients. The greatest advantage of the double-needle microsuture is that each stitch can be placed from the inner side of the arterial wall to the outer side. This "inner-to-outer" stitch secures full-thickness bite and minimizes intimal damage. Safe and reliable anastomosis could be carried out in an unfavorable setting because the double-needle suture offers a high degree of freedom in suture placement.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine, Tokyo, Japan. shimiyam@east.ncc.go.jp
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okazaki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takushima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Mifue
authors.initials: M
authors.lastname: Omori
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Harii
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D001158:Arteries / Q000601:surgery; D050197:Atherosclerosis / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D013536:Suture Techniques / Q000295:instrumentation