Internal mammary artery and vein as recipient vessels in head and neck reconstruction

Importance: Free-tissue transfer for head and neck reconstruction has evolved since the mid-1950s. A variety of different recipient arteries and veins have been described for use in head and neck reconstruction. In our experience, the internal mammary artery (IMA) and internal mammary vein (IMV) have become increasingly important for achieving successful microvascular reconstruction. Objective: To illustrate the efficacy of the IMA and IMV recipient vessels in head and neck reconstruction, highlighting the different techniques used to harvest these vessels and outline decision making when approaching a neck where commonly used vessels are unavailable. Design: Retrospective medical record review. Setting: Outpatient clinic setting. Participants: All free-tissue transfers performed between 2005 and 2011. All patients in whom the IMA or IMV recipient vessels were used were included. Interventions: Twelve cases were performed with IMA and IMV harvest. Main Outcomes and Measures: Donor site, flap used, recipient artery and vein, success of transfer, flap survival, and presence of donor site complications. Results: The IMA and IMV were harvested in 12 patients, with 11 successful free-tissue transfers. In 1 patient, the vessels were unusable, and a regional tissue transfer was performed. Conclusions and Relevance: The IMA and IMV are excellent recipient vessels for use in head and neck reconstruction and should be considered for use in challenging reconstructive cases.