Recipient Vessels in Reconstructive Microsurgery: Anatomy and Technical Considerations

Preface
Contents
Contributors
Part I: Introduction
	1: Recipient Vessels for Microsurgery
		Introduction
		Preoperative Assessment
		Surgical Site Exposure
		Microvascular Anastomoses
		Conclusion
		References
Part II: Head and Neck Reconstruction
	2: External Carotid Branches/External Jugular/Internal Jugular
		Introduction
		Arterial Anatomy and Selection
		Venous Anatomy and Selection
			External Jugular Vein
			Internal Jugular Vein
		Nerve and Lymphatic Anatomy and Considerations
		Conclusion
		References
	3: Minimal Access Approach for Facial Vessels
		Introduction
		Preoperative Considerations
		Relevant Anatomy
		Operative Technique
		Discussion
		Conclusion
		References
	4: Angular Vessels
		Introduction
		Preoperative Considerations
		Relevant Anatomy
		Operative Technique
		Discussion
		Conclusion
		References
	5: Superficial Temporal Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		References
	6: Transverse Cervical Vessels
		Introduction
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		Conclusion
		References
	7: Recipient Vessels: Laryngopharynx Reconstruction
		Introduction
			Upper Cervical Vessels
				Carotid and Jugular Systems
		Applied Anatomy
			Transverse Cervical Vessels
		Surgical Site Exposure
			Vessels Outside the Head and Neck Region
		Discussion
			Algorithm for Recipient Vessel Selection
			Preoperative Assessment Tools
			Technical Pearls
		Conclusion
		References
	8: Recipient Vessels: Voice Reconstruction
		Introduction
		Anatomy of the Larynx and Phonatory Physiology
		Vascular Anatomy of the Neck
			Branches of the Carotid System
			Venous Anatomy of the Neck
			The Transverse Cervical Vessels
			The Thoracoacromial Vessels
			The Cephalic Vein
		Surgical Options for Voice Reconstruction
		Recipient Vessels for Voice Reconstruction: Selection and Surgical Exposure
		Discussion
		References
	9: Recipient Vessels: Esophagus Reconstruction
		Introduction
		Overview of Free Tissue Transfer Options
		Recipient Arteries: External Carotid Arterial System
		Recipient Veins: Internal and External Jugular Venous System
		Recipient Vessels in the Vessel-Depleted Neck
		Contralateral Neck Vessels
		Transverse Cervical Vessels
		Subclavian Artery, Thoracoacromial Vessels, and Internal Mammary Vessels
		Dorsal Scapular Vessels
		Cephalic Vein
		Technique
		Preoperative Assessment
		Anastomosis
		Anticoagulation
		Postoperative Care
		Conclusion
		References
Part III: Trunk Reconstruction
	10: Internal Mammary Vessels: Inframammary and Standard Approach
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
			Inframammary Fold Incision: Modifications in Technique
			Delayed Immediate Reconstruction: Modifications in Technique
		Discussion
		References
	11: Internal Mammary Vessels: Rib-Sparing Approach
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		References
	12: Subscapular-Thoracodorsal and Lateral Thoracic Vessels
		Introduction
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		References
	13: Venous Salvage Using Cephalic Vein/External Jugular Vein
		Introduction
		Anatomy
		Internal Mammary System
		Axillary System
		Venous Outflow Options Other Than the Internal Mammary and Axillary Systems
		External Jugular Vein
		Cephalic Vein
		Discussion
		References
	14: Thoracoacromial Vessels
		Introduction
		Preoperative Assessment
		Preoperative Cutaneous Marking
		Applied Anatomy
		Surgical Site Exposure
			Transmuscular Approach
			Retromuscular Approach
		Discussion
		Summary
		References
	15: Deep Inferior Epigastric Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
			External Approach
			Intra-abdominal Approach
		Discussion
		Conclusion
		References
	16: Intra-abdominal/Intraperitoneal Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
			Gastroepiploic Vessels
			Jejunal Vessels
			Gastroduodenal Vessels
			Inferior Mesenteric Vessels
		Surgical Site Exposure
			Gastroepiploic Vessels
			Jejunal Vessels
			Gastroduodenal Vessels
			Inferior Mesenteric Vessels
		Discussion
		References
	17: Common and Superficial Femoral Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		Summary
		References
	18: Saphenous Arteriovenous Loop
		Introduction
		Indications
		Preoperative Planning
			Surgical Technique
		Complications
		Conclusion
		References
	19: Superficial Circumflex Iliac and Superficial Inferior Epigastric Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		References
	20: Superior Epigastric Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		References
	21: Lumbar Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		Conclusion
		References
	22: Superior Gluteal Vessels
		Introduction
		Preoperative Assessment
		Intraoperative Considerations
		Applied Anatomy
		Surgical Site Exposure
			Medial Approach
			Muscle-Splitting Approach
			Superior-Lateral Approach
			Lateral Approach
			Postoperative Considerations
		Discussion
		References
	23: Inferior Gluteal Vessels
		Introduction
		Applied Anatomy
		Preoperative Assessment
		Surgical Site Exposure
		Postoperative Management
		Discussion
		Conclusion
		References
Part IV: Upper Extremity Reconstruction
	24: Brachial Artery and Basilic/Cephalic Veins
		Introduction
		Preoperative Assessment
		Applied Anatomy
			The Brachial Artery
			The Cephalic, Basilic, and Brachial Veins
		Surgical Site Exposure
		Discussion
		References
	25: Radial Artery
		Introduction
		Applied Anatomy
		Anatomic Variants
		Radial Artery Branches
		Forearm
			Radial Recurrent Artery (RRA)
			Muscular Branches
			Septocutaneous Branches
			Periosteal Branches
		Wrist
			Superficial Palmar Branch (SPB)
			Palmar (Volar) Carpal Branches
			Dorsal Carpal Branches
		Hand
			Princeps Pollicis Artery (PPA)
			First Dorsal Metacarpal Artery (FDMA)
			Radialis Indicis Artery
			Deep Palmar Arch
		Preoperative Assessment
			Allen Test/Modified Allen Test
		Surgical Site Exposure
			Cubital Fossa and Proximal Third of the Forearm
				Microsurgical Indications
			Middle and Distal Thirds of the Forearm
				Microsurgical Indications
			Snuffbox
				Microsurgical Indications
			Princeps Pollicis Artery and the Origin of the Deep Palmar Arch
				Volar Approach
			Dorsal Approach
				Microsurgical Indications
		References
	26: Ulnar Artery
		Introduction
		Applied Anatomy
		Anatomic Variants
		Branches
			Forearm
				Ulnar Recurrent Arteries
				Common Interosseous Artery
				Posterior Interosseous Artery (PIA)
				Interosseous Recurrent Artery (IRA)
				Anterior Interosseous Artery (AIA)
				Muscular Branches
				Septocutaneous Branches
				Periosteal Branches
			Wrist
				Dorsal Branch
				Palmar (Volar) Carpal Branches
				Dorsal Carpal Branches
			Hand
				Superficial Palmar Arch
		Preoperative Assessment
			Allen Test/Modified Allen Test
		Surgical Site Exposure
			Cubital Fossa and Proximal Third of the Forearm
				Microsurgical Indications
			Middle and Distal Thirds of the Forearm
				Microsurgical Indications
			Guyon’s Canal
				Microsurgical Indications
		References
	27: Recipient Vessels: Humerus Reconstruction
		Introduction
		Preoperative Assessment
		Recipient Vessels
			Humerus Reconstruction with Vascularized Fibula
			Complications
		Summary
		Case Example
		References
	28: Recipient Vessels: Ulna Reconstruction
		Introduction
		Etiology
		Anatomy of the Ulna
		Vascular Anatomy of the Forearm
		Preoperative Assessment of the Vascular Anatomy
		Preoperative Modelling for the Planning of Ulna Reconstruction
		Recipient Vessel Exposure in the Forearm
		General Considerations
		Proximal Forearm
		Mid-forearm
		Distal Forearm
		Fibula Flap
		Discussion
		References
	29: Recipient Vessels: Radius Reconstruction
		Introduction
		Preoperative Assessment
		Overview of Vascular Anatomy of the Forearm
		Surgical Exposure of Proximal Radius and the Recipient Vasculature
		Surgical Exposure of Distal Radius and Recipient Vasculature
			Operative Technique
				Free Fibula Osteocutaneous or Musculoseptocutaneous Flap
			Operative Technique
				Free Fibula Osteomusculocutaneous Flap Elevating with Physis
			Postoperative Management
			Nonvascular Complications of Vascularized Fibula Flap
		Discussion
		References
Part V: Lower Extremity Reconstruction
	30: Descending Branch of the Lateral Circumflex Femoral Vessels
		Introduction
		Applied Anatomy
		Recipient Site Preparation
			Proximal-Based Recipient Site
			Distal-Based Recipient Site
		Discussion
		References
	31: Ascending and Transverse Branches of the Lateral Circumflex Femoral Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
		Discussion
		References
	32: Superficial Femoral Vessels and Branches
		Introduction
		Preoperative Assessment
		Applied Anatomy
			Femoral Triangle
			Adductor Canal (Hunter’s Canal)
		Surgical Site Exposure
			Case 1
			Case 2
		Discussion
		Conclusion
		References
	33: Popliteal Vessels and Branches
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
			Suprageniculate Popliteal Artery Exposure
			Midpopliteal Popliteal Artery Exposure
			Infrageniculate Artery Exposure
		Discussion
		Conclusion
		References
	34: Anterior Tibial Vessels and Dorsalis Pedis
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
			Anterior Tibial Artery
			Dorsalis Pedis Artery
		Discussion
			Target Vessel Selection
			Considerations for Zone of Injury and Defect Location
		References
	35: Tibioperoneal Trunk and Posterior Tibial Artery
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Surgical Site Exposure
			Tibioperoneal Trunk and Posterior Exposure of the Posterior Tibial Artery
			Upper Posterior Tibial Artery and Tibioperoneal Trunk Exposure
			Middle Posterior Tibial Artery Exposure
			Lower Posterior Tibial Artery Exposure
		Discussion
		References
	36: Peroneal Vessels
		Introduction
		Anatomy of the Peroneal Vessels and Perforators
		Preoperative Assessment
		Surgical Exposures
		Discussion
			Fitting Peroneal Vessels and Perforators into the Recipient Vessel Algorithm
		References
	37: Recipient Vessels: Femur Reconstruction
		Introduction
		Preoperative Assessment
		Applied Anatomy of the Fibula and Femur
		Femur Reconstruction with Vascularized Fibula
		Fibula Vascular Considerations
		Surgical Site Exposure of Vascular Recipients
		Case Example
		Summary
		References
	38: Recipient Vessels: Tibia Reconstruction
		Introduction
		Anatomy of the Fibula Flap
		Flap Dissection
		Preparation of the Recipient Site and Flap Inset
		Postoperative Care
		Conclusion
		References
	39: Medial Superior and Descending Genicular Vessels
		Introduction
		Preoperative Assessment
		Applied Anatomy
			Medial Superior Genicular Artery
			Descending Genicular Artery
		Surgical Site Exposure
			Medial Superior Genicular Artery
			Descending Genicular Artery
		Discussion
		References
	40: Medial Sural Vessels
		Introduction
		Applied Anatomy
		Surgical Site Exposure
			The Medial Approach
			The Posterior Approach
			The Intramuscular Perforator Approach
		Discussion
		References
Part VI: Miscellaneous Special
	41: Recipient Vessels for Vascularized Lymph Node Transplant
		Introduction
		Preoperative Assessment
		Anatomy and Surgical Technique
			Axilla
			Proximal Forearm
			Wrist
			Thigh
			Lower Leg
			Ankle
		Discussion
		Conclusion
		References
	42: Arteriovenous Loop Graft for Lower Extremity Reconstruction
		Introduction
		Graft Length and Perfusion Pressure
		Staging
		Technical Considerations
			Surgical Technique
		Flow Characteristics
			In Situ Venous Drainage
		Discussion
		Conclusions
		References
	43: Recipient Vessels for Spine and Posterior Trunk Reconstruction
		Introduction
		Preoperative Planning
		Applied Anatomy: Posterior Trunk
		Applied Anatomy: Spine
		Surgical Technique
			Posterior Neck
			Posterior Chest Wall
			Soft Tissue Defects Along the Lumbar Back and Sacral Area
			Cervical Spine
			Thoracic Spine
			Lumbosacral Spine
		Discussion
		Conclusion
		References
	44: Recipient Vessels for Genital Reconstruction
		Introduction
		Preoperative Assessment
		Applied Anatomy
		Recipient Site Exposure
		Discussion
		References
Index