Err on the side of a small coupler. The microvascular anastomotic coupling device is an elegant, friction-fit ring pin device that is becoming more widely used. GEM Microvascular Anastomotic Coupler. Methods A systematic review of the literature was performed in November 2020 across 4 electronic databases and in accordance to the PRISMA guidelines. The System provides the tools for surgeons to perform a secure anastomosis with shorter procedure time and decreased ischemia time compared to traditional suturing. The Microvascular Anastomotic Coupler System (Synovis Micro Companies Alliance, Birmingham, Ala) includes a reusable anastomotic instrument, forceps, vessel-measuring gauge, and implantable couplers. Ordering Information Microvascular Anastomotic Coupling (MAC) System 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. The GEM Microvascular Anastomotic COUPLER System consists of a reusable Anastomotic Instrument, reusable COUPLER Forceps, and a reusable Double-Ended Vessel Measuring Gauge. Baxter. More on Baxter. RESULTS: After starting therapeutic anticoagulation and attempting unsuccessful suture reanastomosis, coupler devices were used for arterial anastomosis, … Select appropriately sized coupler (range from 1 to 4 mm). This review summarises the current applications, efficacy, and troubleshooting of microvascular coupler devices in arterial end-to-end anastomosis. During microvascular reconstruction, a clot at the arterial anastomosis was encountered in both cases. The GEM Microvascular Anastomotic COUPLER System has been specifically designed for use in the anastomosis of veins and arteries normally encountered in microsurgical procedures. The coupler consists of two high-density polyethylene rings and stainless steel pins. The anastomotic coupler for venous anastomosis in free flap surgery is associated with reduced operating times, reduced take-backs to theatre and cost benefits. 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. NOTE: The GEM COUPLER System is completely latex free. Clean adventitia off the ends of the vessels; Measure the caliber of the smaller of the two veins. 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 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. 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. Coupler provides a fast, reliable anastomosis. The GEM COUPLERs are sterile, intended for single-patient use only, and are available in seven sizes. Useful for veins (greater than 1 mm in size). 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