Abstract
“End-to-side” vascular anastomosis was introduced for free-flap transfer in head and neck reconstructive surgery, and the advantages and disadvantages were discussed. In this procedure, the donor artery was anastomosed to the recipient's external carotid artery, and the donor vein was anastomosed to the internal or external jugular vein. Since the caliber of the donor vessels could be enlarged by making a cut-back, and the vessels were anastomosed to the side of large recipient vessels, the indication of “end-to-side” anastomosis was not restricted by the size of vessels. Moreover, the technique was easier than “end-to-end” microvascular anas-tomosis. The presence of arteriosclerosis was considered one of the major problems in conducting the arteriotomy of external carotid artery. The use of arteriotomy clamp and scalpel was helpful to aboid vessel wall damages. It seemed very risky to use this technique for anastomosis of the donor vein to the ligated jugular vein.
