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Head and Neck Surgery

Artery Grafting for Arterial Anastomoses in Free Tissue Transfer Reconstruction

Sunday, October 1, 2023
3:51 PM - 3:57 PM East Coast USA Time
Location: 201AB

    Presenting Author(s)

  • EM

    Eric V. Mastrolonardo, MD

    Resident
    Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    • Co-Author(s)

  • SS

    Sarah M. Sussman, MD

    Resident Physician- Department of Otolaryngology
    The Ohio State University
    Columbus, OH, United States

  • Daniel J. Campbell, MD

    Resident Physician
    Thomas Jefferson University Hospital
    Philadelphia, PA, United States

  • Ramez Philips, MD

    Medical Student
    Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, Pennsylvania, United States

  • LS

    Larissa Sweeny, MD

    Associate Professor, Otolaryngology - Head and Neck Surgery
    University of Miami Health System
    Miami, FL, United States

  • Mark K. Wax, MD

    Professor Otolaryngology/Maxillofacial Surgery, Program Director
    OHSU
    Portland, OR, United States

    • Senior Author(s)

  • Joseph M. Curry, MD

    Professor
    Thomas Jefferson University Hospital
    Wynnewood, PA, United States

Disclosure(s):
Eric V. Mastrolonardo, MD: No relevant relationships to disclose.
Daniel J. Campbell, MD: No relevant relationships to disclose.
Larissa Sweeny, MD: No relevant relationships to disclose.
Mark K. Wax, MD, FACS, FRCS: No relevant relationships to disclose.
Introduction: During head and neck free tissue transfer (FTT) reconstruction, vessel grafting is occasionally utilized to achieve tension-free end-to-end vessel anastomosis; even for arterial anastomoses, vein grafting is generally favored over artery grafting due to ease of harvest. We sought to investigate 30-day surgical outcomes for artery versus vein grafting for arterial anastomoses during these surgeries.

Methods: Patients were retrospectively identified via electronic medical records from 5 institutions from 2004-2022. Patients were included if they underwent head and neck FTT reconstruction requiring vessel grafting for the arterial anastomosis. Chi-square test was used to compare 30-day postoperative outcomes between artery versus vein grafts. P-values of < 0.05 were considered statistically significant.

Results: 43 patients met inclusion criteria. 5 (11.6%) artery and 38 (88.4%) vein grafts were used for arterial anastomoses. Between the two groups, there was no statistically significant difference between the rates of the following 30-day complications: flap failure [artery: n=1 (20%), vein: n=2 (5.3%), p=0.224], wound dehiscence [artery: n=1 (20%), vein: n=12 (31.6%), p=0.596], wound infection [artery: n=0 (0%), vein: n=10 (26.3%); p=0.190], hematoma [artery: n=0 (0%), vein: n=2 (5.3%), p=0.599], fistula formation [artery: n=0 (0%), vein: n=6 (15.8%), p=0.338], hospital readmission [artery: n=0 (0%), vein: n=8 (21.1%); p=0.255], and unplanned return to the operating room [artery: n=1 (20%), vein: n=8 (21.1%), p=0.957].

Conclusions: In head and neck FTT reconstruction, utilization of artery grafts is a viable option for achieving tension-free arterial anastomoses and results in similar postoperative outcomes compared to vein grafts.