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Deep Vein Thrombosis Induced by Stasis in Mice Monitored by High Frequency Ultrasonography
Published on: April 13, 2018
Free tissue transfer and deep vein thrombosis
Dylan J Murray1, Peter C Neligan, Christine B Novak
1Division of Plastic Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|January 22, 2008
Summary
Free tissue transfer for lower limb reconstruction can be complicated by deep venous thrombosis (DVT). Preoperative venous assessment is crucial for successful microvascular surgery in high-risk patients.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Oncology
Background:
- Free tissue transfer is a common reconstructive method for extensive post-oncologic lower limb defects.
- Deep venous thrombosis (DVT) can complicate these procedures, potentially leading to flap failure.
- Preoperative management of DVT with low molecular weight heparin is standard in high-risk patients.
Observation:
- Two cases of free tissue transfer following thigh sarcoma resection in patients with preoperative DVT are presented.
- The first patient experienced flap failure due to venous congestion and thrombosis in the reconstructed femoral vein.
- The second patient achieved flap survival by utilizing the superficial venous system for microvascular anastomosis.
Findings:
- Successful microvascular reconstruction in the presence of DVT depends on careful preoperative planning and assessment of both deep and superficial venous systems.
- Venous congestion and thrombosis in reconstructed deep veins can lead to free flap failure.
- Utilizing the superficial venous system can be a viable alternative for microvascular anastomosis when deep venous reconstruction is compromised.
Implications:
- Thorough preoperative evaluation of venous anatomy is essential for patients undergoing lower extremity free tissue transfer, particularly those with or at high risk for DVT.
- This assessment guides surgical planning to optimize venous outflow and minimize the risk of flap failure.
- Identifying alternative venous conduits, such as the superficial system, can improve outcomes in complex reconstructive cases.
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