Irradiated superficial femoral artery rupture after free flap: A case report and review of the literature

Katharine Hinchcliff, Christine A. Olson, Christopher J. Little, Hakan Orbay, David E Sahar

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Radical oncologic resection can result in large soft tissue defects with exposure of underlying vessels. Unless immediately covered with viable soft tissue, these vessels are vulnerable to desiccation from air exposure and mechanical trauma. Local radiation treatment also contributes to a decline in vessel wall strength. We present an index case of a patient with prolonged exposure of her femoral bone and superficial femoral artery after an initial failed reconstruction of a soft tissue sarcoma resection defect. We provided coverage using a free latissimus dorsi muscle flap. Two weeks after the initial free flap operation, the patient was readmitted to emergency service with profuse bleeding from beneath the free flap. Intraoperative inspection revealed a 2-cm defect of the irradiated superficial femoral artery. The defect was repaired with cryopreserved human arterial graft, and the flapwas reset. This case highlights the importance of immediate coverage of soft tissue defects after oncologic resection. If any vessels are left exposed, they should be closely inspected before a delayed flap coverage to rule out future sources of bleeding that may jeopardize the outcomes of an otherwise successful free flap operation.

Original languageEnglish (US)
Pages (from-to)S15-S18
JournalAnnals of Plastic Surgery
Volume74
DOIs
StatePublished - May 1 2015

Keywords

  • Femoral artery blowout
  • Latissimus dorsi muscle flap
  • Radiotherapy
  • Soft tissue sarcoma

ASJC Scopus subject areas

  • Surgery

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