Iatrogenic thrombosis of the deep inferior epigastric artery during diagnostic angiography—a rare complicating factor during rectus free flap harvest

We describe a 28-year-old man who sustained an open IIIB left ankle fracture dislocation with heel pad avulsion. The patient underwent formal angiography of the left lower extremity, followed by free tissue transfer of a rectus abdominis flap several days later. Intraoperatively, a thrombus was iden...

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Bibliographic Details
Published in:Journal of vascular surgery cases and innovative techniques 2022-12, Vol.8 (4), p.580-582
Main Authors: Langhammer, Christopher G., Miller, Nathan F., Herndon, Carl L., Burke, Allen P., Kundi, Rishi, Pensy, Raymond A.
Format: Article
Language:English
Subjects:
Angiogram
Case report
Flap salvage
Limb salvage
Pedicle thrombus
Rectus abdominis free flap
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Summary:We describe a 28-year-old man who sustained an open IIIB left ankle fracture dislocation with heel pad avulsion. The patient underwent formal angiography of the left lower extremity, followed by free tissue transfer of a rectus abdominis flap several days later. Intraoperatively, a thrombus was identified in the deep inferior epigastric artery above the femoral artery access site requiring thrombectomy. Histologic analysis estimated the thrombus age at 12 to 72 hours, raising concern that the thrombus was induced during angiogram instrumentation. Donor and recipient site-specific risks of arterial instrumentation (including invasive diagnostics) should be considered when planning free tissue transfer.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2022.08.001