Related Experiment Video
Updated: May 5, 2026
07:57
Methods for Acute and Subacute Murine Hindlimb Ischemia
Published on: June 21, 2016
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A Free Bypass Flap for Chronic Limb-threatening Ischemia
Kohei Umekawa1, Takashi Kurabayashi1, Hirotaka Asato1
1From the Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan.
Plastic and Reconstructive Surgery. Global Open
|June 11, 2024
Summary
Free bypass flaps improve foot circulation in chronic limb-threatening ischemia (CLTI) patients. This innovative technique offers a high bypass vessel patency rate, enhancing limb salvage for complex cases.
Area of Science:
- Vascular Surgery
- Reconstructive Surgery
Background:
- Inframalleolar disease is increasingly prevalent in chronic limb-threatening ischemia (CLTI) patients.
- Identifying adequate outflow vessels in the foot is challenging for these patients.
- Free tissue transfer is used, but concerns exist about impeding perfusion of diseased vascular beds.
Purpose of the Study:
- To introduce and evaluate the efficacy of a free bypass flap technique.
- To improve direct perfusion to the affected foot in CLTI patients.
Main Methods:
- Developed a "free bypass flap" combining free tissue transfer with bypass surgery.
- Performed bypass surgery by anastomosing a flap pedicle branch to a diseased foot artery.
- Conducted a retrospective chart review of nine CLTI patients (2018-2023).
Main Results:
- Achieved a 100% flap success rate (n=9).
- Demonstrated high bypass vessel patency (89%, n=8), confirmed by angiography/echo.
- Reported an 89% limb salvage rate (n=8).
Conclusions:
- Free bypass flap surgery enhances overall foot blood circulation.
- The technique shows a high patency rate for bypass vessels.
- It is a valuable method for limb preservation in highly comorbid CLTI patients.
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