Microvascular anastomotic coupler for venous end-to-side anastomoses in head and neck reconstructive surgery

BACKGROUND: The use of coupler devices has become mainstream in microsurgical end-to-end venous anastomoses (EEA) for free flaps in head and neck reconstruction. Reports about end-to-side venous anastomoses (ESA) using a coupler are scarce, though. METHODS: The surgical technique of end-to-side anastomosis using a coupler device is described. End-to-side anastomoses and end-to-end anastomoses with a vascular coupler are compared with respect to postoperative vascular complications. RESULTS: 124 patients were included, 76 with EEA, 48 with ESA. Postoperative venous complications occurred in 5.3% and 2.1%, respectively. CONCLUSIONS: ESA is a valuable alternative to EEA when using a coupler device providing more flexibility to the surgeon. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00405-023-08136-0.