PDF(Pubmed)
Abstract：
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.
摘要：
radial前臂自由皮瓣（RFFF）是用于头颈部重建的主力皮瓣。我们提出了一个不寻常的桡动脉闭塞病例，可能来自之前的经桡动脉心脏导管检查,在一名患者中，该患者在切除鳞状细胞癌后进行了RFFF的口底重建。超声多普勒和艾伦试验的术前评估是正常的。在止血带控制下，皮瓣顺利抬起。然而,皮瓣抬高和止血带释放后，皮瓣灌注不良，动脉的减少显示管腔内有一长段硬纤维斑块。对病历的回顾性审查显示，有通过相同桡动脉进行心脏导管插入的病史。我们讨论了可以防止这种情况发生的各种措施，包括仔细的术前筛查涉及桡动脉的先前程序，反向艾伦试验,多普勒超声,并考虑在没有止血带的情况下进行远端动脉探查。
