Pectoral-Sparing Deltoid Artery Use in the Vessel-Depleted Neck: A Pictorial Essay.

[BACKGROUND] This study demonstrates the role of the deltoid branch artery as a donor vessel for microvascular reconstruction in various free flaps in the vessel-depleted neck.

[METHODS] This is a cohort study that reports our experience with 12 patients treated between January 5, 2020 and January 12, 2020 with free flap reconstruction utilizing the deltoid artery as a donor.

[RESULTS] All patients had vessel-depleted necks secondary to previous surgery (75%), radiotherapy (100%), and/or chemotherapy (66%). Donor sites included radial forearm (n = 4), anterolateral thigh (n = 5), and latissimus dorsi (n = 3). All patients had complete flap survival, and none experienced major increases in morbidity.

[CONCLUSION] Our cohort demonstrated success using the deltoid artery for microvascular anastomosis in patients with vessel-depleted necks. It remains viable despite previous therapies. These data support the deltoid branch with a pectoral-sparing approach as a promising first-line arterial donor for various free flap reconstructions in patients with vessel-depleted necks.