Abstract
Background
Non-suturing alternatives to expedite a microanastomoses while still insuring maximum
patency rates to date have best been achieved using everting ring-pin devices. Although
these so-called couplers have heretofore primarily been used for the venous microanastomosis
during free flap transfers, they have also had limited value for their arterial counterpart.
Methods
Applications for use of the microanastomotic coupler has been extended to repair solitary
arterial injuries in the distal upper extremity. Over the past year, 4 patients specifically
with hand or forearm arterial injuries alone, had rapid coupling of the injured vessels.
Results
Direct end-to-end repair of all hand or forearm arterial injuries using a microanastomotic
coupler was possible in 3 of four cases. Because of the greater extent of injury,
the exception required an interposition vein graft; but that too was coupled to each
end of the divided artery in end-to-end fashion. In no case was there any compromise
of vascular patency.
Conclusion
Although hand perfusion in no individual in this series was ever at jeopardy because
of persistent collaterals, this demonstration of the efficiency and efficacy of this
device may justify future use for critical limb revascularisation.
Keywords
Ring-pin anastomotic coupler - Microvascular surgery - Upper extremity artery repair
