Outcomes of Single Anastomoses for Superficial and Deep-System Venous Drainage of Radial Forearm Free Flaps

Overview

Journal OTO Open

Specialty Otorhinolaryngology

Date 2021 May 17

PMID 33997587

Citations 1

Authors

Mauricio Alejandro Moreno

Luke T Small

James Reed Gardner

Alexandrea H Kim

Emre Vural

Jumin Sunde

Affiliations

Soon will be listed here.

Abstract

Objective: Venous insufficiency occurs in radial forearm free flaps (RFFFs) when either the deep venous system (DVS) or superficial venous system (SVS) is used as the venous outlet. We report our experience using the antecubital perforating vein (APV) in a single-vessel anastomosis to the median-cubital or cephalic vein to drain both systems.

Study Design: Retrospective review.

Setting: Single, academic, tertiary care center.

Methods: Data were collected from 72 patients who underwent RFFF from October 2009 to January 2017. In all cases, DVS and SVS were dissected, and an APV single-vessel anastomosis was attempted.

Results: Anatomical variations precluded single-vessel anastomosis in 11 (15.3%) cases. In 61 (84.7%) cases, single-vessel anastomosis produced unobstructed drainage for DVS and SVS without intrinsic venous insufficiency. Venous thrombosis and total loss occurred in 2 (3.3%) and 1 (1.6%) patients, respectively. Proximal dissection of the cephalic vein addressed a vessel-depleted neck in 3 cases.

Conclusion: The antecubital perforating vein is present and functional in most patients, allowing for single anastomosis techniques for RFFF. Antecubital perforators capture DVS and SVS outflow through a single, extended venous pedicle, eliminating the risk of venous insufficiency and need for vein grafts.

Citing Articles

Efficiency of Cephalic Vein Only Anastomosis During Radial Forearm Free Flap.

Mousa-Doust D, Tran K, Bahat-Dinur A, Kwon J, Deane E, Anderson D J Otolaryngol Head Neck Surg. 2025; 54:19160216241307547.

PMID: 39945247 PMC: 11822809. DOI: 10.1177/19160216241307547.

The Central Facial Defect Reconstruction Using a Radial Forearm Free Flap after Malignant Cutaneous Tumor Ablation.

Cho K, Park J, Eun S J Clin Med. 2023; 12(22).

PMID: 38002760 PMC: 10672586. DOI: 10.3390/jcm12227148.

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