Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland Swelling
Summary:. Late arterial thrombosis of a free flap is rare and usually unsalvageable because it is hard to detect. We herein report 2 cases of arterial thrombosis of a free flap after microvascular head and neck reconstruction due to the combined factors of pedicle artery loop and compression by a sw...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2017-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001446 |
| _version_ | 1818656398559412224 |
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| author | Yu Kagaya, MD Masaki Arikawa, MD Shimpei Miyamoto, MD |
| author_facet | Yu Kagaya, MD Masaki Arikawa, MD Shimpei Miyamoto, MD |
| author_sort | Yu Kagaya, MD |
| collection | DOAJ |
| description | Summary:. Late arterial thrombosis of a free flap is rare and usually unsalvageable because it is hard to detect. We herein report 2 cases of arterial thrombosis of a free flap after microvascular head and neck reconstruction due to the combined factors of pedicle artery loop and compression by a swollen submandibular gland, the occurrence of thrombosis in both of which was > 72 hours after the operation. In case 1, the arterial thrombosis was undetectable, and it was too late for a successful take-back operation, so the flap was lost. However, we applied the lessons learned from case 1 and were able to detect the late arterial thrombosis of case 2 at an early stage; we subsequently salvaged the flap successfully. During the take-back operation in both cases, it was found that the submandibular gland became swollen and compressed the pedicle artery, which then became occluded due to a steep loop formation. Postoperative swelling of the submandibular gland can sometimes compress the vascular pedicle, and complete occlusion of the pedicle artery may occur when it is looped. Meticulous care concerning the geometry of the vascular pedicle is required to avoid such complications. |
| first_indexed | 2024-12-17T03:24:57Z |
| format | Article |
| id | doaj.art-578278a092de4b6ab9eb87614928f35e |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-17T03:24:57Z |
| publishDate | 2017-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-578278a092de4b6ab9eb87614928f35e2022-12-21T22:05:25ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742017-08-0158e144610.1097/GOX.0000000000001446201708000-00021Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland SwellingYu Kagaya, MD0Masaki Arikawa, MD1Shimpei Miyamoto, MD2From the Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.From the Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.From the Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.Summary:. Late arterial thrombosis of a free flap is rare and usually unsalvageable because it is hard to detect. We herein report 2 cases of arterial thrombosis of a free flap after microvascular head and neck reconstruction due to the combined factors of pedicle artery loop and compression by a swollen submandibular gland, the occurrence of thrombosis in both of which was > 72 hours after the operation. In case 1, the arterial thrombosis was undetectable, and it was too late for a successful take-back operation, so the flap was lost. However, we applied the lessons learned from case 1 and were able to detect the late arterial thrombosis of case 2 at an early stage; we subsequently salvaged the flap successfully. During the take-back operation in both cases, it was found that the submandibular gland became swollen and compressed the pedicle artery, which then became occluded due to a steep loop formation. Postoperative swelling of the submandibular gland can sometimes compress the vascular pedicle, and complete occlusion of the pedicle artery may occur when it is looped. Meticulous care concerning the geometry of the vascular pedicle is required to avoid such complications.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001446 |
| spellingShingle | Yu Kagaya, MD Masaki Arikawa, MD Shimpei Miyamoto, MD Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland Swelling Plastic and Reconstructive Surgery, Global Open |
| title | Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland Swelling |
| title_full | Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland Swelling |
| title_fullStr | Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland Swelling |
| title_full_unstemmed | Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland Swelling |
| title_short | Late Arterial Thrombosis after Microvascular Head and Neck Reconstruction due to Combined Factors of Pedicle Artery Loop and Submandibular Gland Swelling |
| title_sort | late arterial thrombosis after microvascular head and neck reconstruction due to combined factors of pedicle artery loop and submandibular gland swelling |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001446 |
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