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Updated: Oct 10, 2026

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Lower limb varicose veins in free fibula flap reconstruction: a surgical case report and scoping review
Sebastian Holm1, Reza Tabrisi2,3
1Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
Background:
Mandibular reconstruction using a vascularized free fibular flap (FFF) remains a gold standard following oral cancer resection. Lower-limb varicose veins are a common manifestation of chronic venous disease, but their potential impact on free-flap viability is largely unexplored in the surgical literature.
Case Presentation:
We present a case of FFF reconstruction in a patient with lower extremity varicose veins, detailing the intraoperative management of venous congestion and the postoperative course.
Methods:
We conducted a scoping review to identify publications addressing venous disease or abnormal venous findings in the context of FFF reconstruction.
Results:
The scoping review identified only two relevant publications.
Conclusion:
This report identifies an evidence gap regarding the relevance of donor-site venous findings in FFF reconstruction. The present case and limited literature are hypothesis-generating and do not establish a causal relationship between superficial varicose veins and flap compromise. Further research is needed to clarify whether targeted venous assessment has a role in selected patients.
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Veins of Lower Limbs
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the knee,...

