Venous Free Flap with Interposition Bypass Graft for Arteriovenous Fistula Preservation: A Case Report

Arch Plast Surg. 2023 Oct 12;50(6):568-572. doi: 10.1055/a-2122-6029. eCollection 2023 Nov.ABSTRACTCutaneous squamous cell carcinoma (CSCC) overlying an arteriovenous fistula (AVF) is rare and presents unique challenges. This case report describes a method of fistula preservation after CSCC excision using a flow-through venous free flap. The saphenous vein of the venous flap was used as flow-through segment for AVF preservation. The flap was inserted along the dorsal aspect of the forearm wound and microvascular anastomosis of the arterial inflow was completed using a vein just proximal to the radiocephalic fistula anastomosis. Venous outflow was established by creating an end-to-end vascular anastomosis between the cephalic vein and the greater saphenous vein. A separate subcutaneous vein was used to provide a low-pressure outflow for the flap to avoid congestion. This case demonstrates an option for AVF preservation that has not been previously described. It also highlights the importance of a multidisciplinary approach for the safe treatment of CSCCs overlying AVFs.PMID:38143846 | PMC:PMC10736209 | DOI:10.1055/a-2122-6029
Source: Archives of Plastic Surgery - Category: Cosmetic Surgery Authors: Source Type: research