Free Flap with Reversed Arterial Flow in the Leg: Case Report

Abstract

A case of distal-third reconstruction of a leg with bone exposure is reported. A rectus abdominis muscle free flap, based on the inferior epigastric artery, was anastomosed to the distal stump of the anterior tibial artery with reversed flow. This technique is suggested as an option for microvascular reconstruction in the distal third of the leg. Anatomic and physiologic details are discussed.

Reconstruction of the aesthetic units of the face with microsurgery: Experience in five years

“…Despite the high number of potential recipient vessels in the head and neck area, we found the facial vessels very reliable, with a constant anatomy, large diameter, and very rarely the need to use a vein graft. We have used both facial artery edges in the facial artery, with normal anterograde flow in one, and with retrograde flow in the other, 9 to provide satisfactory nourishment to the flap. We are studying this concept for a future report.…”

Comparative Study of Different Combinations of Microvascular Anastomosis Types in a Rat Vasospasm Model: Versatility of End-to-Side Venous Anastomosis in Free Tissue Transfer for Extremity Reconstruction

“…[1][2][3] Various types of microvascular anastomoses can be used depending on the flaps and the recipient sites: end-to-end, 4,5 end-to-side, 6,7 flow-through 8 and retrograde. 9,10 Of these, end-to-end and end-to-side anastomoses are the most commonly used. There have been many experimental studies comparing the patency rates of end-to-end and endto-side anastomoses in both arteries and veins, but most of them failed to demonstrate a significant difference.…”

Reverse flow facial artery as recipient vessel for perforator flaps

“…7,[16][17][18] For example, the radial forearm flap was proposed as a distally based pedicled flap before it was used for free tissue transfer. It is well-accepted that flaps such as the reverse radial forearm flap are perfused by distal or retrograde flow.…”