End-to-side venous anastomosis with the internal jugular vein stump: a preliminary report

Abstract

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.