Useful for veins (greater than 1 mm in size). During microvascular reconstruction, a clot at the arterial anastomosis was encountered in both cases. Clean adventitia off the ends of the vessels; Measure the caliber of the smaller of the two veins. The GEM COUPLERs are sterile, intended for single-patient use only, and are available in seven sizes. Baxter. Err on the side of a small coupler. GEM Microvascular Anastomotic COUPLER System™ The Fast, Safe, Easy Way to Perform Microvascular Anastomosis™ The GEM Microvascular Anastomotic COUPLER™ System has been specifically designed for use in the anastomosis of veins and arteries normally encountered in microsurgical procedures. RESULTS: After starting therapeutic anticoagulation and attempting unsuccessful suture reanastomosis, coupler devices were used for arterial anastomosis, … NOTE: The GEM COUPLER System is completely latex free. The GEM Microvascular Anastomotic COUPLER System consists of a reusable Anastomotic Instrument, reusable COUPLER Forceps, and a reusable Double-Ended Vessel Measuring Gauge. The Microvascular Anastomotic Coupler System (Synovis Micro Companies Alliance, Birmingham, Ala) includes a reusable anastomotic instrument, forceps, vessel-measuring gauge, and implantable couplers. Methods A systematic review of the literature was performed in November 2020 across 4 electronic databases and in accordance to the PRISMA guidelines. The microvascular anastomosis remains a technically sensitive and critical determinant of success in free tissue transfer. The anastomotic coupler for venous anastomosis in free flap surgery is associated with reduced operating times, reduced take-backs to theatre and cost benefits. The coupler consists of two high-density polyethylene rings and stainless steel pins. More on Baxter. Select appropriately sized coupler (range from 1 to 4 mm). The GEM Microvascular Anastomotic COUPLER System has been specifically designed for use in the anastomosis of veins and arteries normally encountered in microsurgical procedures. GEM Microvascular Anastomotic Coupler. Arterial anastomosis has been described with the coupler device - this is not part of UIHC routine; Venous anastomosis (end-to-end) Radial forearm free flap: cephalic vein to external jugular vein, Synovis 3.5mm coupler, D. Shonka & N. Pagedar, 2010. This is the first study to demonstrate clear clinical benefits to anastomotic couplers, and suggests that these may be the gold standard for venous microanastomosis. The System provides the tools for surgeons to perform a secure anastomosis with shorter procedure time and decreased ischemia time compared to traditional suturing. Ordering Information Microvascular Anastomotic Coupling (MAC) System In our institution, we routinely perform venous anastomosis with a microvascular anastomotic coupler (GEM Microvascular Anastomotic Coupler; Synovis, Inc., Birmingham, Ala.) for its simplicity and time saving, especially in large-caliber vessels. The microvascular anastomotic coupling device is an elegant, friction-fit ring pin device that is becoming more widely used. Coupler provides a fast, reliable anastomosis. This review summarises the current applications, efficacy, and troubleshooting of microvascular coupler devices in arterial end-to-end anastomosis. The Fast, Safe and Easy Way to Perform a Microvascular Anastomosis The GEM Microvascular Anastomotic COUPLER System (GEM2741CC) has been specifically designed for blood vessel anastomosis. 1 to 4 mm ) the anastomosis of veins and arteries normally encountered in microsurgical procedures to... 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