A Rare Anatomical Variation in the Pedicle of Anterolateral Thigh (ALT) Flap

Free anterolateral thigh (ALT) flap finds its place in the front row among the soft-tissue flaps used for complex reconstruction of various defects. Its versatile tissue component and ease of harvesting with minimal donor site morbidity made it a popular flap. However, its variable vascular anatomy alerts the reconstructive surgeon to remain aware of the common variation and vigilant with regard to unusual variation. Commonly described variations are about the origin and course of pedicle and perforators. There are rare reports regarding the presence of double arteries and single vein in the flap pedicle. Here, the authors describe these unusual anatomical variations in the pedicle of ALT flap, with two arteries and one vein, and discuss the surgical implication of the same.