title: Feasibility of using external jugular vein and its branches as Y- and X-shaped vein grafts for bridging of arterial defects and providing additional arterial sources for free flap applications in rat model.
abstract: BACKGROUND
  Venous grafting has been widely used in microsurgical training. Different types of vascular grafts have been described in experimental models. In this study we describe for the first time the Y- and X-shaped vein grafts (YVG, XVG) with accompanying drain-out branches as a new tool for the microsurgical training and free flap applications in rats.
  
  
  METHODS
  Twelve adult male Lewis rats were used in this study. The dissections were performed to determine the average diameter and harvestable length of vein grafts in eight rats. In four rats vein grafts were applied for bridging of the common carotid artery gap, whereas the drain-out branches were used as the arterial source for single and bilateral free groin flap applications. The venous anastomoses of groin flaps were performed in end-to-end fashion to the external jugular vein and its branches. The patency of anastomoses was checked 72 hours after repair.
  
  
  RESULTS
  The average length of the harvestable vein branches ranged between 5.2 to 11.8 mm. The average surgery time for repair of the arterial gap with the vein grafts was 40 minutes. The ischemia time for single and bilateral groin flap transfer using YVG and XVG was 30 and 70 minutes, respectively. The patency of the interpositional vein graft was 100%. Flap survival rates were 50%.
  
  
  CONCLUSIONS
  These vein grafts can be used as an alternative technique for reconstruction of tissue defects that require arterial gap repair with single or multiple free flap applications and also as a new microsurgical training model.
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Can
authors.initials: C
authors.lastname: Ozturk
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Safak
authors.initials: S
authors.lastname: Uygur
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Cemile Nurdan
authors.initials: CN
authors.lastname: Ozturk
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Lukaszuk
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Maria
authors.initials: M
authors.lastname: Siemionow
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D020212:Carotid Artery Injuries / Q000601:surgery*; D017536:Carotid Artery, Common / Q000601:surgery*; D005240:Feasibility Studies; D058752:Free Tissue Flaps / Q000098:blood supply*; D006085:Graft Survival; D007601:Jugular Veins / Q000033:anatomy & histology / Q000637:transplantation*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D061646:Operative Time; D011917:Rats, Inbred Lew; D014654:Vascular Patency