Salvage of femoropedal bypass graft complicated by interval gangrene and vein graft blowout using a flow-through radial forearm fasciocutaneous free flap

M. A. Gooden, A. T. Gentile, C. P. Demas, S. S. Berman, J. L. Mills

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

We report the case of a 71-year-old man who had interval gangrene of his calf with subsequent vein graft blowout 3 months after undergoing a femoral- to-dorsalis pedis saphenous vein bypass grafting procedure. To provide wound coverage, restore vascular continuity, and preserve functional ambulation, a flow-through radial forearm fasciocutaneous free flap was interposed between cut ends of the bypass graft. Venous drainage of the flap was from the cephalic vein to the popliteal vein. At 1 month after the operation, the patient had complete wound healing and began to ambulate. At 11 months an asymptomatic high-grade stenosis in the distal radial artery segment of the reconstruction was successfully treated with percutaneous angioplasty. After 22 months of follow-up there have been no further complications, and the patient continues to have full, functional ambulation. The radial forearm flow-through free flap allows single-stage restoration of bypass graft continuity and coverage of extensive, complex tissue defects. This technique represents a novel approach to this difficult problem and provides a viable alternative to major limb amputation.

Original languageEnglish (US)
Pages (from-to)711-714
Number of pages4
JournalJournal of vascular surgery
Volume26
Issue number4
DOIs
StatePublished - Jan 1 1997

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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