Topic
Vena comitans
About: Vena comitans is a research topic. Over the lifetime, 29 publications have been published within this topic receiving 324 citations.
Papers
TL;DR: Venous blood velocity is significantly greater after a single venous anastomosis than in either of two veins when two venousAnastomoses are performed, and these results argue against routinely performing two venOUS anastOMoses.
Abstract: Background: The authors' goal was to determine whether one or two venous anastomoses results in superior blood flow through microvascular free flaps. Methods: During flap harvest, blood velocity was measured in each of two venae comitantes using Doppler ultrasonography. Next, one of the two veins was occluded with a microvascular clamp and blood velocity was measured in the open vein. The clamp was then removed and placed on the other vein, and blood velocity was measured in the first vein. The pedicle was divided and microvascular anastomosis of either one or two veins was performed. Venous blood velocity was then compared between flaps with one versus two venous anastomoses. Results: Eighty-one free flaps were performed. Before pedicle division, the peak venous blood velocity in each of the two venae comitantes averaged 6.3 ± 4.8 cm/second. When one of the veins was occluded, the peak venous blood velocity increased to 19.5 ± 17.3 cm/second (p < 0.00001). One venous anastomosis was performed in 69 flaps and two venous anastomoses were performed in 12 flaps. The mean blood velocity in flaps in which one venous anastomosis was performed was greater than the mean blood velocity in either vein when two venous anastomoses were performed (13.1 ± 7.3 cm/second versus 7.5 ± 4.3 cm/ second, respectively; p = 0.001). Conclusions: When one vena comitans is occluded, blood velocity in the second vena comitans increases significantly. Venous blood velocity is significantly greater after a single venous anastomosis than in either of two veins when two venous anastomoses are performed. These results argue against routinely performing two venous anastomoses.
115 citations
TL;DR: The retrograde limb of the internal mammary vein is an option as a recipient vein in DIEP breast reconstruction and may prove useful in cases with intraoperative congestion in a single vein flap, in Cases with co-dominant superficial and deep venous systems, and in cases in which double-pedicle free flaps are used for unilateral breast reconstruction.
Abstract: Background: The deep inferior epigastric perforator (DIEP) flap has become an increasingly popular option for postmastectomy reconstruction. The purpose of this study was to evaluate the retrograde limb of the internal mammary vein as a recipient vein in DIEP breast reconstruction. Methods: Fifteen consecutive DIEP flaps in 13 patients were transferred with anastomosis of one DIEP vena comitans to the antegrade internal mammary vein and the other DIEP vena comitans to the retrograde internal mammary vein. The deep inferior epigastric artery was anastomosed to the antegrade internal mammary artery. Blood flow through the retrograde internal mammary vein was evaluated with intraoperative duplex ultrasound. Results: Thirty venous anastomoses in 15 DIEP flaps for breast reconstruction were performed over a 4-month period to investigate the retrograde limb of the internal mammary vein as a potential recipient vein. No evidence of intraoperative venous congestion was seen. Retrograde blood flow was demonstrated using intraoperative duplex imaging and clinical examination. All 15 flaps were successful. Conclusions: The retrograde limb of the internal mammary vein is an option as a recipient vein in DIEP breast reconstruction. This outflow option may prove useful in cases with intraoperative congestion in a single vein flap, in cases with co-dominant superficial and deep venous systems, and in cases in which double-pedicle free flaps are used for unilateral breast reconstruction.
62 citations
TL;DR: The RIMV is a reliable, useful option when the antegrade vein is not available, or when a second recipient vein is needed, and was less but not significantly different from flow in the AIMV.
Abstract: Background:The internal mammary vein (IMV) is commonly used as a recipient vessel in the direction of antegrade flow for free flap breast reconstruction. Recent reports show that the distal IMV is valveless and can accommodate retrograde flow. We sought to quantify blood velocity and flow through the distal IMV following free tissue transfer. Methods:Ten free flap breast reconstructions were performed. The larger vena comitans of the DIEA was anastomosed to the antegrade internal mammary vein (AIMV). The smaller vena comitans was anastomosed to the retrograde internal mammary vein (RIMV) in five free flaps, and the superficial inferior epigastric vein (SIEV) was anastomosed to the RIMV in five other free flaps.Results:The mean diameter of the larger vena comitans (3.4 ± 0.5 mm) was significantly greater than that of the smaller vena comitans (2.4 ± 0.4 mm; P = 0.003). Mean velocity in the AIMV after anastomosis was 10.13 ± 5.21 mm/s compared with 7.01 ± 2.93 mm/s in the RIMV (P = 0.12). Mean blood flow in the AIMV and the RIMV was 81.33 ± 52.81 mm3/s and 57.84 ± 45.11 mm3/s, respectively (P = 0.30). Mean blood flow in the RIMV was not significantly affected by whether the donor vein was the smaller vena comitans (70.78 ± 61.43 mm3/s) or the SIEV (44.90 ± 19.70 mm3/s; P = 0.40).Conclusions:Blood flow in the RIMV was less but not significantly different from flow in the AIMV. The difference is likely due to the smaller-sized donor vein anastomosed to the RIMV. The RIMV is a reliable, useful option when the antegrade vein is not available, or when a second recipient vein is needed. © 2011 Wiley Periodicals, Inc. Microsurgery, 2011.
27 citations
TL;DR: A new anterior tibial flap has been designed and applied clinically in two cases as a reverse-flow island flap, anastomosing one vena comitans to a superficial vein at the edge of the wound in order to avoid venous congestion.
26 citations
TL;DR: The radiologic findings of the collateral venous pathways in the transverse mesocolon and the greater omentum associated with pancreatic diseases were described and the accompanying arterial anatomy was correlated.
Abstract: OBJECTIVE. The purpose of this study was to describe the radiologic findings of the collateral venous pathways in the transverse mesocolon and the greater omentum associated with pancreatic diseases and to correlate these venous pathways and the accompanying arterial anatomy.CONCLUSION. The collateral pathway in the transverse mesocolon consists of the inferior mesenteric vein, left transverse colic vein, marginal vein of the transverse colon, and middle colic vein. The pathway in the greater omentum consists of anastomosis of the left and right epiploic veins deriving from the gastroepiploic vein. The former pathway is the vena comitans of Riolan's arch and the latter is the vena comitans of the arch of Barkow.
21 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 1 |
| 2019 | 2 |
| 2018 | 2 |
| 2017 | 1 |
| 2016 | 1 |
| 2015 | 1 |