Salvage arterial anastomosis using a microvascular coupler in head and neck free flap reconstruction.

Microvascular free tissue transfer is essential in complex head and neck reconstruction. The mainstay of microvascular anastomosis has classically been the suture technique, but the coupling device has emerged as a valuable alternative. Couplers are commonly used for venous anastomoses, but most head and neck reconstructive surgeons do not routinely couple arteries. However, coupling may afford reconstructive surgeons a unique tool for addressing difficult arterial anastomoses. In this case report, we describe the successful use of a microvascular coupler for salvage arterial anastomosis after recurrent thrombosis following multiple attempts at suture anastomosis in head and neck free flap reconstruction.