Descending branch of the lateral circumflex femoral artery as a recipient vessel for vascularized fibular grafts: Clinical case series

Abstract

Vascularized fibular grafts (VFG) are used for the treatment of femoral head avascular necrosis, osteomyelitis, nonunions, and excessive bone defects. Mostly the ascending branch of the lateral circumflex femoral artery (LCFA) or first or second perforating branch of the profound femoral artery is used for the customary recipient vessel. In this report, an alternative technique of using descending branch of LCFA in VFG surgery and its clinical results are reported. Sixteen patients (13 men and 3 women) underwent VFG surgery between the years 2005 and 2012. Predicted etiologies were: ANFH in 10 hips, traumatic femur neck pseudoarthrosis in 4 hips, tumor in 1 hip, and 1 femur shaft defect due to osteomyelitis. Patients' average age at the time of surgery was 29 years (range, 14-43 years). All patients were treated with VFG. All of the grafts survived and none of the patients needed any revision surgery. One had superficial wound infection, one developed peroneal nerve palsy, and one had trochanteric bursitis. The follow-up time was 36 months (range 20-72). It is believed that the descending branch of LCFA is a reliable alternative for anastomosis in VFG surgery.

Free Tissue Transfer to the Knee for a Complex Wound Coverage When Good Recipient Vessels Are Not Available

“…The DB of the LCFVs can provide reliable blood supply for free tissue transfer to the knee 15,16. Given its popularity due to most of the surgeon’s experience with the ALT flap, it is often a straightforward dissection for potential alternative use as a recipient vessel.…”

“…The DB of the LCFVs can provide reliable blood supply for free tissue transfer to the knee. 15,16 Given its popularity due to most of the surgeon's experience with the ALT flap, it is often a straightforward dissection for potential alternative use as a re-cipient vessel. The DB in the thigh is versatile when dissected at length to be placed in close proximity to the knee, making it an excellent recipient vessel for free tissue transfer to the knee.…”

Application of Free Flow‐Through Anterolateral Thigh Flap for the Reconstruction of an Extremity Soft Tissue Defect Requiring Vascularization

“…It proceeds downward, while sending perforators to supply the skin and muscles around the anterolateral aspect of the thigh (Figure 2). Usually, the descending branch has an external diameter of more than 2 mm at the proximal end with a pedicle of more than 8 cm in length (Figure 3) [18,19]. When a larger flap is required, more than two perforator arteries should be preserved between the flap and pedicle.…”

The descending branch of the lateral circumflex femoral artery as an alternative conduit for coronary artery bypass grafting: Experience from an anatomical, radiological and histological study

“…Whereas the branching patterns of the circumflex femoral arteries have been thoroughly mapped by Vazquez et al () and the clinical anatomy of the medial femoral artery has been reported in detail by Clarke and Colborn (), the variability and clinical anatomy of the DBLCFA itself are mostly unknown and only exceptional case studies have been reported (Goel et al, ). Despite being used successfully as the pedicle of anterolateral thigh flaps or fibular grafts in plastic and reconstructive surgery and orthopedics (Choi et al, ; Gokhan et al, ; Jia et al, ), the DBLCFA is still extremely rarely used for CABG. Despite preliminary studies on its preparation (Loskot et al, ), anatomical and histological studies linked with angiographic assessment of atherosclerosis in patients undergoing CABG are still lacking, and this became the rationale for the present study.…”