If arterial thrombosis develops after a free flap operation, we need to remove the thrombosis and surgically re-anastomose the arteries. For this, the entire arterial thrombosis area is surgically removed and we may have to use a vein graft. The vein used for grafting must be selected according to factors such as the difference in diameter from the artery, time required for collection, state, and sacrifice of the donor site. We hypothesized that these problems can be solved using a comitant vein of the flap that was transplanted. We were able to achieve good results using this method in two cases of arterial thrombosis after transplantation of a free rectus abdominis myocutaneous flap during head and neck reconstruction. We consider this method useful for feeding arteries shortened by arterial thrombosis in cases with two comitant veins.
