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Venous congestive flap salvage with subcutaneous rtPA
Author(s) -
Tran Nho V.,
Bishop Allen T.,
Convery Phyllis A.,
Yu Art Y.
Publication year - 2006
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20254
Subject(s) - medicine , microsurgery , urokinase , thrombolysis , surgery , streptokinase , free flap , venous thrombosis , thrombosis , tissue plasminogen activator , cardiology , myocardial infarction
Free‐flap success has been the rule with technical advancements in microsurgery. Despite improvements, thrombosis and flap loss still occur occasionally. Salvaging a sick flap can be a harrowing experience, even in the most experienced hands. Thrombolysis using intravenous and intra‐arterial urokinase, streptokinase, and/or tissue plasminogen activator (rtPA) administered through the flap vascular pedicle has been reported in free‐flap salvages. In such situations, success depends on early diagnosis and emergent exploration. Recently, we successfully used rtPA subcutaneously to salvage a venous congested free transverse rectus abdominus myocutaneous (TRAM) flap. Here, we report on that case. © 2006 Wiley‐Liss, Inc. Microsurgery, 2006.