The "Rolled-up sleeve" technique for microvascular venousanastomosis in head and neck reconstruction: animal study and clinical series

Background: Venous anastomosis is challenging especially when encountering the thin recipient vein wall in the head and neck region. The authors developed the "rolled-up sleeve" technique to solve this scenario. Methods: An animal study was performed to access the safety and reliability of the "rolled-up sleeve" technique. This techniquewas performed in 53 consecutive patients during head and neck reconstruction. Results: In the animal study, all anastomoses were patent. Histological analysis revealed neo-endothelialization over the anastomotic site. This technique was applied to 59 recipient veins: branch of internal jugular vein (27), external jugular vein (17), superficial temporal vein (9), retromandibular vein (4), facial vein (2), and internalmammary vein (2).No venous thrombosis occurred in these clinical series. Conclusions: The "rolled-up sleeve" technique is a useful procedure that can be performed safely to dealwith thin vascular walls for venous anastomoses in head and neck reconstructions.