Mj. Wheatley et Tr. Meltzer, THE ROLE OF VASCULAR PEDICLE THROMBECTOMY IN THE MANAGEMENT OF COMPROMISED FREE TISSUE TRANSFERS, Annals of plastic surgery, 36(4), 1996, pp. 360-364
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.