A Free Bypass Flap for Chronic Limb-threatening Ischemia.
Plast Reconstr Surg Glob Open
; 12(6): e5875, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38859803
ABSTRACT
Background:
Recently, significant inframalleolar disease seems to increase in chronic limb-threatening ischemia (CLTI) patients, making identifying sufficient outflow vessels in the foot challenging. In these difficult situations, free tissue transfer is a valuable tool to provide a low-resistance vascular bed to the affected part. However, there remains concern that free tissue transfer may impede adequate perfusion of the higher resistance diseased vascular bed.Methods:
To improve perfusion of the affected area directly, the authors have developed a concept of a free bypass flap, adding bypass surgery to free tissue transfer. After anastomosis with the recipient vessels in a conventional manner for free tissue transfer, bypass surgery to the foot is performed by anastomosis of the branch of the flap pedicle with the diseased artery to the foot. A retrospective chart review of nine CLTI patients was performed to analyze the outcomes of free bypass flap transfer between 2018 and 2023.Results:
The flap success rate was 100% (nâ =â 9). Postoperative angiography or echo confirmed the patency of all but one bypass vessel (nâ =â 8). There were six fatalities, however, due to causes other than foot lesions, with an average observation period of 16 months. The limb salvage rate was 89% (nâ =â 8).Conclusions:
A free bypass flap enhances the overall blood circulation to the foot. Due to its high patency rate of bypass vessels, it is a valuable method for preserving the limbs of highly comorbid patients with CLTI.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Plast Reconstr Surg Glob Open
/
Plastic and reconstructive surgery. Global open
Year:
2024
Document type:
Article
Affiliation country:
Japan
Country of publication:
United States