TY - JOUR AU - McLaughlin, Mariel; Porter, Brooke E.; Cohen-Shohet, Rachel; Leyngold, Mark M. TI - Safety of Coupled Arterial Anastomosis in Autologous Breast Reconstruction SN - 0743-684X SN - 1098-8947 PY - 2020 JO - J Reconstr Microsurg JF - Journal of Reconstructive Microsurgery LA - EN VL - 37 IS - 02 SP - 132 EP - 135 DA - 2020/08/20 KW - microsurgery KW - coupled anastomosis KW - coupling device KW - breast reconstruction KW - arterial anastomosis AB - Background This study compares the outcomes of coupled versus hand-sewn arterial anastomosis in microvascular breast reconstruction.Methods Retrospective chart review of breast reconstruction free flaps performed between 2013 and 2018 was conducted. Primary end points included flap loss, intraoperative arterial anastomosis revision, and operating room takeback. The decision to couple the arterial anastomosis was based on patient's age, surgeon's preference, history of radiation, and vessel quality. All anastomoses were performed under ×3.5 loupe magnification to internal mammary or thoracodorsal vessels.Results Authors reviewed 104 free flaps; two were lost in hand-sewn group; no flaps were lost in coupled group. There was no significant difference in anastomotic revision rate between coupled and hand-sewn arterial anastomosis (p = 0.186) or return to operating room (OR) between coupled and hand-sewn flaps (p = 1.000). Reasons for takeback included venous congestion and hematoma.Conclusion This study reflects that coupled arterial anastomosis in breast reconstruction may be safely performed without increased risk in anastomotic revision, takeback, or flap loss. Decision to couple should be based on surgeon skill, patient age and history, and assessment of flap and recipient site vasculature. PB - Thieme Medical Publishers, Inc. DO - 10.1055/s-0040-1715585 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1715585 ER -