Salvage operations of free tissue transfer following internal jugular venous thrombosis: A review of 4 cases

The internal jugular vein (IJV) is used as the optimal recipient for free‐tissue transfer in reconstruction following modified radical neck dissection. Some reports documented rare cases of flap compromise following IJV thrombosis, but large sample studies are few. We present cases of emergent explo...

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Bibliographic Details
Published in:Microsurgery 2005, Vol.25 (3), p.191-195
Main Authors: Miyasaka, Muneo, Ichikawa, Kota, Nishimura, Masaki, Yamazaki, Akihisa, Taira, Hiroyuki, Imagawa, Kotaro, Tanino, Ryuzaburo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
General aspects
Head and Neck Neoplasms - surgery
Humans
Jugular Veins
Male
Medical sciences
Microsurgery
Middle Aged
Neck Dissection
Postoperative Complications
Reconstructive Surgical Procedures
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgical Flaps - adverse effects
Surgical Flaps - blood supply
Thrombosis - etiology
Thrombosis - surgery
Tissue Transplantation - adverse effects
Tissue Transplantation - methods
Wounds and Injuries - etiology
Wounds and Injuries - surgery
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Summary:The internal jugular vein (IJV) is used as the optimal recipient for free‐tissue transfer in reconstruction following modified radical neck dissection. Some reports documented rare cases of flap compromise following IJV thrombosis, but large sample studies are few. We present cases of emergent exploration and an analysis of factors to improve salvage rates of compromise due to IJV thrombosis. From a survey of 756 patients, four developed congestion due to IJV thrombosis and returned to the operating room. A restrospective analysis was made from the case records.This represents a rate of 0.5% for the entire series. Three flaps survived,and one failed. Detection of compromise ranged from 7–25 h postoperatively. All four IJVs recovered to provide adequate drainage after thrombectomy.While flap compromise following IJV thrombosis is rare, careful observation and early exploration are crucial for salvage, as in other microvascular venous crises. © 2005 Wiley‐Liss, Inc. Microsurgery 25:00–00 2005.
ISSN:0738-1085
1098-2752
DOI:10.1002/micr.20104