The safety of acute perioperative MRI in microvascular skull base reconstruction utilizing a ferromagnetic microvascular anastomotic device

Microvascular tree tissue transfer provides unprecedented reliability in the immediate reconstruction of complex cranial base defects. Refinements in instrumentation have resulted in microvascular coupling systems designed to facilitate anastomotic performance and reliability. The Microvascular Anastomotic Coupling Device (MACD) is in broad clinical use. Many of its characteristics have been described, yet unknown is the effect of clinical MRI electromagnetic fields on the device, which is composed, in part, of ferromagnetic type 316 stainless steel. Possible effects include anastomotic disruption, vessel torquing, heating, and thrombosis. Imaging performed before the anastomosis is anchored by scar tissue or flap independence of the pedicle blood supply may have catastrophic effects. MACD implants were evaluated for displacement within a 1.5 Tesla magnetic field. No change in displacement was observed. Clinical experience involving acute postoperative magnetic resonance imaging of critical free tissue transfers anastomosed with the MACD confirms laboratory findings. MRI may be considered a safe modality for acute perioperative diagnostic imaging of free tissue transfers anastomosed with the MACD.