Download PDF
J Reconstr Microsurg 1989; 5(3): 231-234
DOI: 10.1055/s-2007-1006872
ORIGINAL ARTICLE

© 1989 by Thieme Medical Publishers, Inc.

Microvascular Thrombolysis to Salvage a Free Flap Using Human Recombinant Tissue Plasminogen Activator

Gary M. Fudem, Robert L. Walton
  • Department of Plastic and Reconstructive Surgery, University of Massachusetts Medical Center, Worcester, Massachusetts
Further Information

Publication History

Accepted for publication 1988

Publication Date:
08 March 2008 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Nonsurgical thrombolysis using tissue plasminogen activator (t-PA) in conjunction with intravenous heparin infusion was successfully used to salvage a free flap with acutely decreased arterial inflow thought to be due to anastomotic thrombosis. Intravenous infusion (12 mg/hr) of t-PA was stopped after 15 min of therapy when spontaneous bleeding was noted at the groin flap donor site. Concomitant treatment with intravenous heparin resulted in rapid improvement of flap perfusion and ultimately complete survival without surgical intervention.

This report suggests that in selected cases, target-specific anticoagulant therapy may be beneficial in salvaging microvascular reconstructions complicated by thrombosis. Further experience is warranted to define more clearly the role, the risks, and the extended benefits of this new mode of nonsurgical therapy.