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Free flap failure in an anticardiolipin antibody‐positive patient with neoplasm–A case report
Author(s) -
Asai Emiko,
Okouchi Masayuki,
Momiyama Masanori,
Kajikawa Akiyoshi,
Ueda Kazuki
Publication year - 2010
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.20734
Subject(s) - medicine , surgery , thrombosis , antiphospholipid syndrome , catastrophic antiphospholipid syndrome , anticardiolipin antibodies , antibody , neoplasm , pathology , immunology
We present herein a case of massive arterial thrombosis of a free rectus abdominal musculocutaneous flap used for reconstructive surgery of gingival carcinoma that could not be rescued. A 54‐year‐old woman underwent the operation. She had experienced two miscarriages in her 20s, but medical history was otherwise uneventful. Intraoperatively, the anastomosed artery often showed massive arterial thrombosis, and the flaps had become necrotic after bilateral flaps were used. Laboratory findings, 7 days postoperatively, showed high levels of immunoglobulin G anticardiolipin antibody. This value normalized by 2 months postoperatively after using chemotherapy. This case does not match the criteria for antiphospholipid syndrome, but some English‐language reports have shown rising antiphospholipid antibody levels, particularly anticardiolipin antibodies, in patients with neoplasm. In those cases, levels have normalized after successful therapy. Antiphospholipid antibody levels should be examined before surgery to identify risks of hypercoagulability. © 2010 Wiley‐Liss, Inc. Microsurgery, 2010.