Free Flaps in Patients with Advanced Arteriosclerosis of the Tibial Vessels: Mini Vein Graft to the Peroneal Artery

Alexander Haumer, MD, PhD; Nicole E. Speck, MD; David E. Kurlander, MD; Thomas Wolff, MD; Edin Mujagic, MD; Alexander Lunger, MD; Martin D. Haug, MD; Dirk J. Schaefer, MD; Tarek Ismail, MD

doi:10.1097/GOX.0000000000005814

Plastic and Reconstructive Surgery, Global Open (May 2024)

Free Flaps in Patients with Advanced Arteriosclerosis of the Tibial Vessels: Mini Vein Graft to the Peroneal Artery

Alexander Haumer, MD, PhD,
Nicole E. Speck, MD,
David E. Kurlander, MD,
Thomas Wolff, MD,
Edin Mujagic, MD,
Alexander Lunger, MD,
Martin D. Haug, MD,
Dirk J. Schaefer, MD,
Tarek Ismail, MD

Affiliations

Alexander Haumer, MD, PhD: From the * Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
Nicole E. Speck, MD: From the * Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
David E. Kurlander, MD: † Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, Ill.
Thomas Wolff, MD: ‡ Vascular Surgery and Organ Transplantation, University Hospital Basel, Basel, Switzerland.
Edin Mujagic, MD: ‡ Vascular Surgery and Organ Transplantation, University Hospital Basel, Basel, Switzerland.
Alexander Lunger, MD: From the * Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
Martin D. Haug, MD: From the * Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
Dirk J. Schaefer, MD: From the * Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
Tarek Ismail, MD: From the * Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland

DOI: https://doi.org/10.1097/GOX.0000000000005814
Journal volume & issue: Vol. 12, no. 5
p. e5814

Abstract

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Summary:. Lower extremity reconstruction with free flaps in patients with only peroneal artery runoff remains a challenge. Here, we present a novel technique for reconstruction of medial defects in the distal leg using a medial approach to the peroneal artery and a short interposition vein graft anastomosed end to side to the peroneal artery. A retrospective, single-center study was performed including all patients who underwent lower extremity reconstruction with free flaps anastomosed to the peroneal artery using a mini vein graft from November 2020 to March 2022. The primary outcome measure was limb salvage. Secondary endpoints were flap survival and postoperative complications. Seven patients received lower extremity free flap reconstruction with a mini vein graft to the peroneal artery. Flap loss rate was 0%. Limb salvage was achieved in five patients (71%). At 6-month follow-up, all patients were ambulatory. One patient died 1 month after surgery due to heart failure. Mini vein graft to the peroneal artery allows reliable and safe free flap reconstruction of distal leg defects in patients with only peroneal artery runoff.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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