Distal revascularization and microvascular free tissue transfer: An alternative to amputation in ischemic lesions of the lower extremity Susan E. Briggs,

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Presentation transcript:

Distal revascularization and microvascular free tissue transfer: An alternative to amputation in ischemic lesions of the lower extremity Susan E. Briggs, M.D., Joseph C. Banis, M.D., Hermann Kaebnick, M.D., Bruce Silverberg, M.D., Robert D. Acland, M.D. Journal of Vascular Surgery Volume 2, Issue 6, Pages 806-811 (November 1985) DOI: 10.1016/0741-5214(85)90126-0 Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1A B. A, Arteriogram after revascularization demonstrating junction of saphenous vein bypass to posterior tibial artery, with single-vessel runoff to pedal arch. B, Transmetatarsal amputation defect of left foot, with unhealthy bacterially colonized granulation tissue over subjacent tendon and bone. Journal of Vascular Surgery 1985 2, 806-811DOI: (10.1016/0741-5214(85)90126-0) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1C E. C, Pattern of radial forearm skin flap vascularized by radial artery and vein, with potential for cutaneous sensory reconstruction by nerve anastomosis. D, Flap elevated, with artery and vein pedicle demonstrated superiorly, and lateral antebrachial cutaneous nerve demonstrated inferiorly. E, Reconstructed defect in early postoperative period, with photo-plethysmography monitoring device in place. Journal of Vascular Surgery 1985 2, 806-811DOI: (10.1016/0741-5214(85)90126-0) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2A C. A, Necrotic defect (3 × 8 cm) of left posterior ankle involving tendo Achillis. B, Design of left scapular free flap showing relationship to scapular tip, and schematic demonstration of vascular supply. C, Healed reconstruction 3 months postoperatively. Journal of Vascular Surgery 1985 2, 806-811DOI: (10.1016/0741-5214(85)90126-0) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 D. Arteriogram after reconstruction demonstrating saphenous vein bypass to distal posterior tibial artery, with free flap pedicle arising from vein bypass graft noted just to left of vein bypass, proceeding distally to supply flap tissue. Journal of Vascular Surgery 1985 2, 806-811DOI: (10.1016/0741-5214(85)90126-0) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions