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Recipient vessel selection for microvascular chest wall reconstruction: A narrative review and decision support
Rushabh Shah1, Chloe Jordan1, Krzysztof Sosnowski2
1Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge, UK.
JPRAS Open
|July 28, 2026
Summary
Selecting recipient vessels is key for successful microvascular chest wall reconstruction. This review offers a framework to guide vessel choice, considering patient factors and intraoperative findings for better outcomes.
Area of Science:
- Microsurgery
- Reconstructive Surgery
- Vascular Anatomy
Background:
- Recipient vessel selection is crucial for successful microvascular chest wall reconstruction.
- Commonly used vessels (internal mammary, thoracodorsal) may be compromised by prior interventions.
- A systematic approach to vessel selection is lacking.
Purpose of the Study:
- To review current evidence on recipient vessel selection in microvascular chest wall reconstruction.
- To propose a structured, evidence-informed decision-support framework for vessel selection.
- To aid preoperative planning and intraoperative strategy in complex reconstructions.
Main Methods:
- A comprehensive narrative literature review was performed.
- Databases searched included PubMed, Medline, Embase, and Web of Science.
- Studies included were peer-reviewed, reporting clinical outcomes, anatomical considerations, or vessel-specific complications.
Main Results:
- Numerous recipient vessel options exist, including internal mammary, thoracodorsal, and perforator vessels, as well as vein grafts.
- Each vessel option has unique advantages and limitations influenced by patient-specific factors and intraoperative conditions.
- Current guidance is fragmented, often limited to specific procedures or institutional practices.
Conclusions:
- A structured decision-support framework is proposed to guide recipient vessel selection.
- The framework aims to optimize preoperative planning and intraoperative decision-making.
- Final vessel choice must be individualized based on patient factors and intraoperative findings.
