Spiral saphenous vein graft for replacement of internal jugular vein: a series of case reports.

Bilateral radical neck dissection with internal jugular vein extirpation, be it simultaneous or staged, results in severe cephalic venous hypertension. Symptoms remit with time, however, acutely contribute to the morbidity of the procedure. Internal jugular vein replacement using autogenous saphenous vein that is fashioned into a spiral conduit has been used in three patients undergoing bilateral or second side radical neck dissection. The technique entails construction of a large vein conduit by wrapping saphenous vein around a chest tube in a spiral fashion. Patients treated had objective relief of the acute venous hypertension based on cephalic venous pressure measurements. The three patients undergoing the spiral vein grafting were notable for the lack of any expected symptoms derived from venous hypertension, and postoperative venograms demonstrate graft patency at one to two weeks.