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J Reconstr Microsurg 1992; 8(4): 277-282
DOI: 10.1055/s-2007-1006708
ORIGINAL ARTICLE

© 1992 by Thieme Medical Publishers, Inc.

Peripheral Arteriovenous Anastomosis: An Alternative Technique in a Free Flap Transfer

Vladimir B. Sidorov, Mark D. Rechter, Vladimir K. Minachenko
  • Department of Plastic and Reconstructive Microsurgery and Department of Operative Surgery and Topographic Anatomy, Yaroslavl Medical Institute, Yaroslavl, Russia. Dr. Sidorov is currently a Fellow in the Department of Plastic and Reconstructive Surgery at Eastern Virginia Medical School, Norfolk, VA
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Publication History

Accepted for publication 1992

Publication Date:
08 March 2008 (online)

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ABSTRACT

Prevention of thrombosis in the inflow and outflow vessels of a free flap is a problem of current interest. The method of creating a peripheral arteriovenous anastomosis within a free flap was validated in an experimental study and substantiated in a clinical case. No thrombotic complications were observed in 16 transfers of saphenous fasciocutaneous flaps in a dog model, as well as in an elderly patient with free radial forearm flap transfer to an irradiated foot. Scanning electron microscopy of the venous anastomosis proximal to the arteriovenous fistula revealed the difference of pathologic changes as early as 4 hr following surgery. It is the conclusion of the authors, that performing a distal arteriovenous fistula in a free flap, is an effective procedure for prevention of early occlusion in a proximally anastomosed artery and vein.