Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Treatment of Intraoperative Thrombosis and Spasm in Free Tissue Transfers Using the Fogarty Catheter

포가티 카테터를 이용한 유리조직 전이술 시 수술 중 혈전 및 연축의 치료

  • Lee, Seung Ryul (Department of Plastic and Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Yun, Young Mook (Department of Plastic and Reconstructive Surgery, College of Medicine, Chungnam National University) ;
  • Oh, Sang-Ha (Department of Plastic and Reconstructive Surgery, College of Medicine, Chungnam National University)
  • 이승렬 (충남대학교 의과대학 성형외과학교실) ;
  • 윤영묵 (충남대학교 의과대학 성형외과학교실) ;
  • 오상하 (충남대학교 의과대학 성형외과학교실)
  • Received : 2007.11.21
  • Published : 2008.03.10
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Abstract

Purpose: Microvascular free tissue transfer has become a reliable technique for the reconstruction of complex wounds. Occasionally, unexpected intraoperative thrombosis and/or spasm of recipient artery might be annoying problems even for the technically competent microvascular surgeons. If such problems are not treated properly, they will inevitably cause to flap failure. Methods: From January 2006 to February 2007, soft tissue reconstructions by free tissue transfers were performed on 21 patients having complex defects in the lower extremity. Although segmental revision and various pharmacologic agents were repeatedly applied, arterial occlusions were not managed in 6 cases. For removal of thrombi and release of spasm, Fogarty No. 2 or No. 3 catheters were inserted into the lumen to the proximal recipient artery. Its balloon was then inflated after passing through a resistant area. Next, the catheter was gently withdrawn backward. Results: After the Fogarty catheter was inserted two or three times, the pulsatile arterial flow was restored. When the catheter was inserted into the lumen, a feeling of resistance existed in a 5-10cm more proximal portion that could not be easily accessed from the vascular end. After the reestablishment of blood flow, successful anastomoses were achieved and immediate rethrombosis or spasm did not occur. No long-term sequelae associated with balloon trauma to the arterial wall were observed. Conclusion: The use of the Fogarty catheter can be an effective method in treating pedicle thrombosis and spasm. This is a very simple and rapid technique that offers microvascular surgeons another option to increase the success rate of microvascular anastomosis in free tissue transfers.

Keywords

Acknowledgement

Supported by : 충남대학교

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