J Reconstr Microsurg 2009; 25(1): 035-038
DOI: 10.1055/s-0028-1090608
© Thieme Medical Publishers

Analysis of Flow Changes to the Foot after Sacrifice of One of the Major Arteries

Ahmet Sönmez1 , İhsan Akpinar2 , Tevfik Şatir1 , Nihal Durmuş1 , Mehmet Bayramiçli1
  • 1Department of Plastic and Reconstructive Surgery, Marmara University Medical School, İstanbul, Turkey
  • 2Department of Radiology, Marmara University Medical School, İstanbul, Turkey
Further Information

Publication History

Publication Date:
21 October 2008 (online)

ABSTRACT

The objective of this study was to find out whether a compensatory increase in blood flow to the foot is observed after sacrifice of one of the tibial arteries. Eleven patients who had one of the tibial arteries as the recipient artery of free tissue transfer to their lower extremities were included. The arterial diameter, cross-sectional area, maximum flow velocity, minimum flow velocity, and flow rate were measured by a Doppler ultrasound in the nonrecipient tibial artery and perforating peroneal artery in the operated limb. The same parameters were measured in the anterior and posterior tibial arteries and the perforating peroneal artery in the contralateral limb. The arterial diameter, cross-sectional area, flow velocity, and flow rate were increased significantly in the nonrecipient tibial artery of the operated limb with respect to the same artery on the contralateral limb. The same changes were not demonstrated in the perforating branch of the peroneal artery. Total blood flow to the foot in the operated extremity was not different from that of the nonoperated foot. The results reveal that if a major feeder to the foot is sacrificed, the other tibial artery compensates for it, and resting blood supply to the foot is not altered.

REFERENCES

  • 1 Suominen S, Ahovuo J, Asko-Seljavaara S. Donor site morbidity of radial forearm flaps: a clinical and ultrasonographic evaluation.  Scand J Plast Reconstr Surg Hand Surg. 1996;  30 57-61
  • 2 Meland N B, Core G B, Hoverman V R. The radial forearm flap donor site: should we vein graft the artery? A comparative study.  Plast Reconstr Surg. 1993;  91 865-870
  • 3 Richardson D, Fisher S E, Vaughan E D, Brown J S. Radial forearm flap donor-site complications and morbidity: a prospective study.  Plast Reconstr Surg. 1997;  99 109-115
  • 4 Brenner P, Berger A, Caspary L. Angiologic observations following autologous vein grafting and free radial artery flap elevation.  J Reconstr Microsurg. 1988;  4 297-301
  • 5 Ciria-Llorens G, Gomez-Cia T, Melendez T. Analysis of flow changes in forearm arteries after raising the radial forearm flap: a prospective study using colour duplex imaging.  Br J Plast Surg. 1999;  52 440-444
  • 6 Royse A G, Royse C F, Maleskar A, Garg A. Harvest of the radial artery for coronary artery surgery preserves maximal blood flow of the forearm.  Ann Thorac Surg. 2004;  78 539-542
  • 7 Bayramiçli M, Tetik C, Sönmez A, Gürünlüoğlu R, Baltaci F. Reliability of primary vein grafts in lower extremity free tissue transfers.  Ann Plast Surg. 2002;  48 21-29
  • 8 Canadian Cardiovascular Society .2005 Canadian Cardiovascular Society Consensus Conference Peripheral arterial disease. Available at: http://www.ccs.ca/download/draft_full_document_3_pdf Accessed June 26, 2006
  • 9 Hollinshead W H. Anatomy for Surgeons. Vol 3. 2nd ed. New York, NY; Harper & Row 1969: 854-873
  • 10 Williams P L, Warwick R. Gray's Anatomy. 36th ed. Edinburgh, UK; Churchill Livingstone 1980: 734-735
  • 11 Ciria-Llorens G, Gomez-Cia T. Hand blood supply in radial forearm flap donor extremities: a qualitative analysis using Doppler examination.  J Hand Surg [Br]. 2001;  26(2) 125-128
  • 12 Iida Y, Numata T, Shiba K, Nagata H, Terada N, Konno A. Hemodynamic changes of the hand after radial forearm flap harvesting.  Ann Plast Surg. 2002;  49 156-160
  • 13 Chong W CF, Ong P JL, Hayward C S, Collins P, Moat N E. Effects of radial artery harvesting on forearm function and blood flow.  Ann Thorac Surg. 2003;  75 1171-1174
  • 14 Guyton A C. Textbook of Medical Physiology. 8th ed. Philadelphia, PA; WB Saunders 1991: 159-169

Ahmet SönmezM.D. 

Marmara Üniversitesi Hastanesi, Plastik ve Rekonstrüktif Cerrahi A.D., Tophanelioğlu Cad. No: 13-15

81190 Altunizade, İstanbul, Turkey

Email: ahsonmez@yahoo.com

    >