gms | German Medical Science

Introduction: There is often a discrepancy between the defect area, the available vessels and the length of the pedicle. The use of veins and arteries as vascular graft is an opportunity for reconstruction after Tumor surgery. The V. saphena magna is an alternative graft which can be used both at the arterial and the venous branch of circulation. The following study is about vessel grafts used in the reconstructive head and neck surgery.

Material and methods: From 2000 to 2012 all patients who underwent free-flap reconstruction for head or neck cancer defect and use of interposition graft were catalogued. Patients included 5 women and 28 men. The Vena saphena has been used in 28 situations as an arterial and in 30 situations as a venous interposition graft. Three arterial grafts were inserted into the arterial branch of circulation two of those have been A. thoracodorsalis and one time A. radialis. Additional a subcutaneous vein of the lower leg was used in one case for arterial reconstruction. For reconstruction of the venous branch 6 other veins have been used (twice jugular vein, twice V. thoracodorsalis and twice forearm vein both in one case).

Results: The complication rate for V. saphena interposition grafts was observed in 10% (3/30) in the venous branch and 3.5 % (1/28) in the arterial branch. The non shaphenic interpositions showed a complication rate of 50% (2/4) in the arterial branch an 17% (1/6) in the venous branch of circulation.

Conclusion: We have shown that use of V. saphena grafts is safe and reliable. It can be used as vascular graft for veins and arteries. Other grafts were associates with a higher rate of thrombotic complications.