Everter-Assisted Arterial Coupling in Abdominal-Based Breast Reconstruction: A Preclinical Study and Retrospective Feasibility Case Series

Background/Objectives: Arterial coupling in microsurgery remains technically challenging despite widespread venous coupler adoption. We developed a novel everter device to facilitate arterial anastomosis using mechanical couplers and evaluated its feasibility and potential efficiency in abdominal-based breast reconstruction.

Methods

Five pigs underwent paired superior epigastric artery flap reconstruction with everter-assisted and hand-sewn arterial anastomoses, analyzed using a paired t-test. A retrospective clinical series included 12 patients, 22 reconstructed breasts, 14 coupling attempts, and 8 primary hand-sewn recipient arterial anastomoses. The primary clinical outcome was successful coupling without revision or conversion. Clinical timing comparisons were descriptive.