Related Experiment Video
Updated: Feb 23, 2026

Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency
Published on: January 15, 2017
Venous Complications in One Versus Two Vein Anastomoses in Head and Neck Free Flaps
Sobia F Khaja1, Nathan Rubin2, Rodrigo Bayon3
11 Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Objective:
The purpose of this study was to compare rates of reexploration and flap failure in patients with 1- and 2-vein anastomoses in free flap reconstructions.
Methods:
Retrospective chart review of 300 patients undergoing free flap reconstruction to head and neck defects from 2010 to 2014.
Results:
One venous anastomosis was performed in 229 patients, and 2 venous anastomoses were performed in 71 patients. The 1-vein group had significantly more reexplorations in the operating room (36/229, 15.7%) compared with the 2-vein group (4/71, 5.6%; P = .028), even when controlling for flap type ( P = .022). This finding remained true among radial forearm flaps (17/81, 21% vs 3/53, 5.7%; P = .024). The number of venous anastomoses was not significantly associated with flap failure, though patients with flap failure did have a significantly greater proportion of venous issues ( P < .001).
Conclusions:
Two-vein anastomoses do not appear to reduce rates of flap failure or postoperative venous thrombosis but are associated with a lower number of reexplorations in the operating room even after accounting for differences in flap types and surgeons.
Related Concept Videos
Veins of Head and Neck
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
Anastomoses
Anastomoses can be formed at arterial, venous, and lymphatic vessels.
Arterial Anastomosis: These occur between arteries. They...
Varicose Veins II: Diagnostic Studies and Interprofessional Care
Hemodialysis I: Introduction
Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...

