Indirect revascularization of the lower extremity by means of microvascular free-muscle flap—A preliminary report Kenneth C. Shestak, MD, Douglas L.

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Presentation transcript:

Indirect revascularization of the lower extremity by means of microvascular free-muscle flap—A preliminary report Kenneth C. Shestak, MD, Douglas L. Hendricks, MD, Marshall W. Webster, MD Journal of Vascular Surgery Volume 12, Issue 5, Pages 581-585 (November 1990) DOI: 10.1016/0741-5214(90)90015-3 Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Nonhealing ischemic ulcer dorsum of foot with exposed extensor tendons of second and third toes. Journal of Vascular Surgery 1990 12, 581-585DOI: (10.1016/0741-5214(90)90015-3) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Lower extremity arteriogram reveals severe occlusive disease of popliteal trifurcation with faint segmental reconstitution of anterior tibial artery in middle third of lower leg (double arrows), without visualization of any vessels distal to this. Journal of Vascular Surgery 1990 12, 581-585DOI: (10.1016/0741-5214(90)90015-3) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Reverse saphenous vein graft from proximal popliteal artery with anastomosis directly to latissimus dorsi free flap. Journal of Vascular Surgery 1990 12, 581-585DOI: (10.1016/0741-5214(90)90015-3) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Six-week postoperative arteriogram shows vein graft, patent anastomosis to thoracodorsal artery, intramuscular arterial arcade, and “new” vessels (solid black arrows) anastomosing with the native vessels of foot (open arrow). Journal of Vascular Surgery 1990 12, 581-585DOI: (10.1016/0741-5214(90)90015-3) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Two-year postoperative view of foot shows healed flap and stable wound coverage. Journal of Vascular Surgery 1990 12, 581-585DOI: (10.1016/0741-5214(90)90015-3) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions