Review and update on the use of the microanastomotic coupler device for arterial anastomosis in free tissue transfer

B El Baba; W Watfa; L Youssef; P G Di Summa; P Bou Khalil; A R Jurjus; D B Loyens; S Sertel; R A Jurjus

doi:10.1016/j.bjoms.2020.06.019

Review and update on the use of the microanastomotic coupler device for arterial anastomosis in free tissue transfer

Br J Oral Maxillofac Surg. 2021 Jan;59(1):16-20. doi: 10.1016/j.bjoms.2020.06.019. Epub 2020 Jul 1.

Authors

B El Baba¹, W Watfa², L Youssef³, P G Di Summa⁴, P Bou Khalil⁵, A R Jurjus⁵, D B Loyens⁶, S Sertel⁷, R A Jurjus⁸

Affiliations

¹ Division of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
² Plastic Surgery Division, St George Hospital University Medical Center, Beirut, Lebanon; Plastic Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, University of Lausanne, Switzerland. Electronic address: [email protected].
³ Faculty of Nursing and Health Sciences, Notre Dame University, Zouk Mosbeh, Lebanon.
⁴ Plastic Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, University of Lausanne, Switzerland.
⁵ Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
⁶ Instituto de Ciencias Biomedicas Abel Salazar da Universidade do Porto, Porto, Portugal.
⁷ Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
⁸ Faculty of Medicine, George Washington University, Washington D.C., USA.

PMID: 32620301
DOI: 10.1016/j.bjoms.2020.06.019

Abstract

While a simple interrupted sutured anastomosis remains the gold standard in microsurgery, the introduction of the microanastomotic coupler device (MACD) has decreased procedure time and thrombosis risk, and improved the patency of venous anastomoses. The aim of this review is to update the evidence-based advantages of the MACD on arteries, based on clinical and experimental data, and to compare them to the hand-sewn approach in free flap transfer. All relevant articles that appeared in the PubMed and Medline/Ovid databases during the past three decades were reviewed. After exclusions, 11 studies were retained and discussed. The MACD had a generally shorter arterial anastomosis time, with improved flap survival and reduced ischaemia compared with the hand-sewn approach. The use of the MACD in arterial anastomosis is an efficient and less time-consuming alternative to the hand-sewn technique, provided that the selection of vessels is appropriate and the vessel diameter is large enough to do the anastomosis.

Keywords: Anastomosis; arterial; coupler; free tissue transfer; synovis; unilink.

Publication types

Review

MeSH terms

Anastomosis, Surgical
Arteries / surgery
Free Tissue Flaps*
Humans
Microsurgery
Plastic Surgery Procedures*
Retrospective Studies