An unusual anatomical variant of the vascular anatomy in the anterolateral thigh free flap

Bhujel, Nabina; Johnston, Colin James; Parmar, Sat; Martin, Tim

doi:10.1016/j.ijom.2009.05.014

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…In their case, the flap pedicle was having two arteries with two normal venae comitantes. 5 Our case was having variation in arterial component with double arteries as well as in the venous anatomy with a single comitant vein; thus, different from the case reported by Bhujel et al…”

Section: Discussioncontrasting

confidence: 70%

A Rare Anatomical Variation in the Pedicle of Anterolateral Thigh (ALT) Flap

Mishra

Sahu

2021

Indian J Plast Surg

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Free anterolateral thigh (ALT) flap finds its place in the front row among the soft-tissue flaps used for complex reconstruction of various defects. Its versatile tissue component and ease of harvesting with minimal donor site morbidity made it a popular flap. However, its variable vascular anatomy alerts the reconstructive surgeon to remain aware of the common variation and vigilant with regard to unusual variation. Commonly described variations are about the origin and course of pedicle and perforators. There are rare reports regarding the presence of double arteries and single vein in the flap pedicle. Here, the authors describe these unusual anatomical variations in the pedicle of ALT flap, with two arteries and one vein, and discuss the surgical implication of the same.

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Section: Discussioncontrasting

confidence: 70%

A Rare Anatomical Variation in the Pedicle of Anterolateral Thigh (ALT) Flap

Mishra

Sahu

2021

Indian J Plast Surg

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“…Several papers have described the anatomical variations of the pedicle. For example, one paper described a case of duplication of the descending branch of the LCF artery [5]. In our case, the variance in the vasculature did not seem to impact the vascular flap's integrity.…”

Section: Discussionmentioning

confidence: 44%

A Case Report of Aberrant Vascular Anatomy of the Anterolateral Thigh Flap

Sagheer

Reschly

2019

Cureus

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Soft tissue free flaps are used for a variety of head and neck reconstructions. The anterolateral thigh (ALT) flap has been a versatile tool in head and neck reconstruction since the mainstream use of microvascular anastomosis for free tissue transfer. The ALT flap has a known history of variable vascular anatomy. Most of this variability lies within perforator anatomy and vascular aberrations distal to the lateral circumflex femoral artery (LCF). Few vascular aberrancies have been described proximal to the LCF. Here we present a case of report of an ALT whose arterial vascular pedicle was a branch directly off the femoral artery. The case highlights an unusual anatomical variant of the ALT flap, and the importance of a thorough and meticulous dissection.

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“…ALT is preferred for scalp reconstruction, for medium size defects [22][23][24][25][26]. The main disadvantage of the ALT flap is unpredictable vascular anatomy, which can increase the surgery time [27,28]. The perforator arteries require meticulous dissection and are less resistant to compression, contamination or infection [28].…”

Section: Discussionmentioning

confidence: 99%

Invasive basosquamous cell carcinoma of the head treated with wide excision and reconstruction with fascia lata graft and two muscle flaps. Case report

Chelmuș¹,

Dobreanu²,

Tripa³

et al. 2015

Arch Clin Cases

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Background: Basosquamous carcinoma (BSC) is a variant of basal cell carcinoma subtype that is locally aggressive with high tendency for recurrence and metastasis and a poor prognosis. Up to 95% are located in head and neck area. Treatment for invasive BSC with aggressive growth pattern is wide excision and reconstruction. Complex defects require free tissue transfer to protect underlying structures and to sustain the adjuvant radiotherapy.Case report: A 57 year-old male presented with ulcerated, bleeding tumors in frontal and periauricular area, identified as BSC on biopsy. CT-scan revealed contact to dura mater. Wide excision included frontal bone and dura mater, frontal sinus, lateral orbital wall and exenteration, ear en-bloc with parotid gland. Dura mater was replaced with fascia lata graft, frontal sinus was filled with pedicled temporalis muscle and 20/25 cm soft tissue defect was covered with free Latissimus dorsi muscle anastomosed to superior thyroid artery and internal jugular vein branch, respectively. The muscle was skin grafted 14 days later.Results: Postoperative recovery was complicated: cerebrospinal fluid leak, extradural hematoma, posthemorrhagic anemia, pneumonia, and withdrawal syndrome, remitted under specific treatment. Muscle flap survived entirely with skin graft fully integrated. Positive margins on dura mater and mastoid bone required radiotherapy.Conclusions: Wide excision of head invasive BSC resulted in complex defect reconstructed with fascia lata graft, temporalis muscle and Latissimus dorsi free flap grafted secondarily. Short-term evaluation showed no recurrence and good life-quality; follow-up is needed to evaluate long-term results. Interdisciplinary approach is the key for patient's successful treatment.

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An unusual anatomical variant of the vascular anatomy in the anterolateral thigh free flap

Cited by 7 publications

References 6 publications

A Rare Anatomical Variation in the Pedicle of Anterolateral Thigh (ALT) Flap

A Rare Anatomical Variation in the Pedicle of Anterolateral Thigh (ALT) Flap

A Case Report of Aberrant Vascular Anatomy of the Anterolateral Thigh Flap

Invasive basosquamous cell carcinoma of the head treated with wide excision and reconstruction with fascia lata graft and two muscle flaps. Case report

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