Increasing the flow output by Y-shaped microvascular anastomosis.

In this paper the authors present a new type of microvascular anastomosis to overcome two major inconveniences in microsurgery: "flow discrepancy" and vessel size discrepancy between the donor and the recipient vessels. A Y-shaped anastomosis is an end-to-end anastomosis between three vessels: two small ones on one side and a larger vessel on the opposite site. Both arterial and venous anastomoses can be performed in this way. The blood flow can go across the anastomosis in both directions. Hemodynamically, this increases the blood output through the anastomosed vessels. The surgical technique and main clinical applications of the Y anastomosis are described in detail. Indications and advantages are discussed.