title: Systematic review: anastomotic microvascular device.
abstract: BACKGROUND
  Anastomotic microvascular device has gained popularity in reconstructive microsurgery over the last two decades. A systematic literature search has been carried out in the use of the venous coupler device in microsurgery to assess its impact on patency rate in microsurgery.
  
  
  METHODS
  Using key words related to the topic, a literature search of major databases was carried out. Selection was undertaken on two level screening. From the literature search 53 potential articles were identified. Of these 13 met both levels of screening for the final critical analysis.
  
  
  RESULTS
  A total of 2976 venous anastomoses with coupler device were carried out in the 13 studies with a combined thrombosis in 46 veins reported, giving an average 98.5% patency and a variation in thrombosis rate ranging from 0 to 3%.
  
  
  CONCLUSIONS
  The venous coupler device serves as a powerful instrument in microsurgery by achieving high patency rate. More importantly the data suggests less variation in thrombosis rate compared to hand-sewn venous anastomosis.
authors.affiliation: Imperial College Healthcare NHS Trust, Charing Cross Hospital, Plastic & Reconstructive Surgery Department, Fulham Palace Road, London W6 8RF, United Kingdom. Electronic address: Ardehali@hotmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Ardehali
authors.affiliation: Imperial College Healthcare NHS Trust, Charing Cross Hospital, Plastic & Reconstructive Surgery Department, Fulham Palace Road, London W6 8RF, United Kingdom.
authors.forename: A N
authors.initials: AN
authors.lastname: Morritt
authors.affiliation: Imperial College Healthcare NHS Trust, Charing Cross Hospital, Plastic & Reconstructive Surgery Department, Fulham Palace Road, London W6 8RF, United Kingdom; University of Oxford, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Jain
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D057868:Anastomotic Leak / Q000517:prevention & control*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D020246:Venous Thrombosis / Q000517:prevention & control
keywords: 3M anastomotic device; Anastomotic device; Microsurgery; Unilink; Venous coupler