THE ROLE OF VASCULAR PEDICLE THROMBECTOMY IN THE MANAGEMENT OF COMPROMISED FREE TISSUE TRANSFERS

Microvascular free tissue transfer has become a very reliable reconstr uctive technique. Occasionally, flap compromise will occur and will re quire urgent flap reexploration, In the setting of complete thrombosis of pedicle vessels, thrombectomy using Fogarty #2 and #3 catheters ca n be effective in restoring vascular patency. Seven flaps with arteria l, venous, or both vessel thrombosis were managed with thrombectomy at the time of reexploration and anastomotic revision. Six of the flaps were completely salvaged and the seventh was partially salvaged, Promp tness in reexploration increased the likelihood of complete flap salva ge. The use of postthrombectomy heparinization was associated with a 5 0% complication rate in this series. Thrombectomy of free flap vessels can be safely performed and is associated with a low incidence of ret hrombosis.