Arterial T and Y grafts

Area of Science:

• Vascular surgery
• Microsurgery
• Reconstructive surgery

Background:

• Arterial anastomotic complications and vessel wall defects pose challenges in reconstructive surgery.
• Free flap transfers, such as latissimus dorsi or scapular flaps, require robust arterial supply.
• Existing methods for arterial reconstruction may be limited in specific clinical scenarios.

Observation:

• An autogenous arterial T graft, harvested from axillary artery segments (subscapular, circumflex scapular, thoracodorsal), was successfully used to salvage a thrombosed arterial end-to-side anastomosis.
• The T-graft design allows for the replacement of diseased or defective arterial segments.
• The arterial Y graft configuration, using the same vessels, can revascularize two distal vessels from a single proximal source.

Findings:

• The arterial T graft provides a viable solution for managing thrombosed arterial anastomoses.
• This technique is applicable for arterial reconstruction in cases of vessel wall defects, stenosis, obliteration, or disease during free flap procedures.
• The large diameter of the harvested axillary artery segments facilitates matching with recipient vessels in the lower leg and forearm.

Implications:

• The arterial T graft offers a novel and effective reconstructive option in vascular surgery.
• This approach enhances the success rates of free flap transfers by providing reliable arterial inflow.
• The versatility of the T and Y graft configurations expands the armamentarium for managing complex arterial reconstructions.