Arterial occlusion secondary to prior cardiac catheterization in a radial forearm flap-lessons learnt from an unusual case.

Autor: Zhang SL; Section of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Woodlands Health, Singapore 737628, Singapore., Chung BZW; Section of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore., Ng HW; Section of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Jazyk: angličtina
Zdroj: Journal of surgical case reports [J Surg Case Rep] 2024 Jun 04; Vol. 2024 (6), pp. rjae391. Date of Electronic Publication: 2024 Jun 04 (Print Publication: 2024).
DOI: 10.1093/jscr/rjae391
Abstrakt: The radial forearm free flap (RFFF) is a workhorse flap for head and neck reconstruction. We present an unusual case of radial artery occlusion, likely from previous transradial cardiac catheterization, in a patient for whom an RFFF was raised for floor of mouth reconstruction following resection of squamous cell carcinoma. Pre-operative assessment with ultrasound Doppler and an Allen test was normal. The flap was raised uneventfully under tourniquet control. However, following flap elevation and tourniquet release, poor flap perfusion was noted, and cutback of the artery revealed a long segment of hard fibrous plaque within the lumen. Retrospective review of medical records showed a history of cardiac catheterization via the same radial artery. We discuss various measures that can prevent this occurrence, including careful pre-operative screening of previous procedures involving the radial artery, the reverse Allen test, Doppler ultrasound, and consideration of distal arterial exploration without a tourniquet.
Competing Interests: None declared.
(Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2024.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje