Venae Comitantes as a Source of Vein Grafts

ABSTRACT

The use of vein grafts is commonplace and often essential in microvascular surgery. Typically, these are obtained from the superficial venous system, and most commonly from the lower extremity using branches or segments of the greater or lesser saphenous veins. Unfortunately, on rare occasions these usual donor sites may have been totally exploited. This potential dilemma can be solved by using the deep venae comitantes as autogenous vein grafts. By way of example, these can be venae comitantes of the free flap itself, or via salvage of parts using a vena comitans that accompanied a major limb source vessel.

Vein graft - vena comitans - free flap - microsurgery

REFRENCES

• 1 Germann G, Steinau H U. The clinical reliability of vein grafts in free-flap transfer.  J Reconstr Microsurg. 1996;  12 11-17
• 2 Hallock G G. Venous outflow simplified by the cephalic vein loop.  Ann Plast Surg. 1988;  21 427-429
• 3 Khouri R K, Cooley B C, Kunselman A R et al.. International Microvascular Research Group A. Prospective study of microvascular free-flap surgery and outcome.  Plast Reconstr Surg. 1998;  102 711-721
• 4 Salibian A H, Rogers F R, Lamb R C. Microvascular gastrocnemius muscle transfer to the distal leg using saphenous vein grafts.  Plast Reconstr Surg. 1984;  73 302-307
• 5 Hallock G G. Vein coupler to simplify the end-to-side microanastomosis.  Eur J Plast Surg. 1989;  12 117-118
• 6 Hallock G G, Rice D C. An endoscopic subcutaneous dissector for obtaining vein grafts.  Ann Plast Surg. 1998;  41 595-599
• 7 Hallock G G. The interposition arteriovenous loop revisited.  J Reconstr Microsurg. 1988;  4 155-160
• 8 Hallock G G. The cephalic vein in microsurgery.  Microsurgery. 1993;  14 482-486
• 9 Lewis H G, Morrison C M, Kennedy P T, Herbert K J. Arterial reconstruction using the basilic vein from the zone of injury in pediatric supracondylar humeral fractures: a clinical and radiological series.  Plast Reconstr Surg. 2003;  111 1159-1163
• 10 Villafane O, Yap L H, Wilson Y. Use of the superficial inferior epigastric vein as an interpositional vein graft in pedicled TRAM reconstruction.  Br J Plast Surg. 2001;  54 648-649
• 11 Sukkar S M, Daw J A, Chandler J, Dumanian G A. Gracilis muscle free flap transfer using a radial artery/venae comitantes composite vascular pedicle.  Plast Reconstr Surg. 2001;  108 156-161
• 12 Ayhan S, Demirtas Y, Findikcioglu F. Perforator vein as an interpositional graft for free perforator flap.  Plast Reconstr Surg. 2005;  115 1445
• 13 Hallock G G. Caution in using the Chinese radial forearm flap.  Plast Reconstr Surg. 1986;  77 164-165
• 14 Liang M D, Narayanan K, Moosa H H. The use of cryopreserved venous allografts in free tissue transfers-practical and aesthetic considerations.  Ann Plast Surg. 1990;  25 417-420