Carotid artery and soft tissue reconstruction with superficial femoral artery-sartorius muscle-anteromedial thigh chimeric free flap: A case report and review of the literature
Issued Date
2022-07-01
Resource Type
ISSN
07381085
eISSN
10982752
Scopus ID
2-s2.0-85131800934
Pubmed ID
35702811
Journal Title
Microsurgery
Volume
42
Issue
5
Start Page
504
End Page
511
Rights Holder(s)
SCOPUS
Bibliographic Citation
Microsurgery Vol.42 No.5 (2022) , 504-511
Suggested Citation
Ciudad P., Kaciulyte J., Agko M., Kiranantawat K., Nicoli F., Lo Torto F., Chen H.C. Carotid artery and soft tissue reconstruction with superficial femoral artery-sartorius muscle-anteromedial thigh chimeric free flap: A case report and review of the literature. Microsurgery Vol.42 No.5 (2022) , 504-511. 511. doi:10.1002/micr.30925 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85763
Title
Carotid artery and soft tissue reconstruction with superficial femoral artery-sartorius muscle-anteromedial thigh chimeric free flap: A case report and review of the literature
Other Contributor(s)
Abstract
Tumoral involvement of the carotid artery may require en-bloc resection in order to achieve a better regional control. Among the carotid reconstruction methods at disposal, autologous tissues appear to be more reliable in cases with high risk of infection and poor tissue healing like in radiated necks. We describe a case of a 55 year old man, who suffered from recurrent squamous cell carcinoma in the neck region, invading the common carotid artery. After en-bloc resection of the tumor together with skin, internal jugular vein, vagus nerve and common carotid artery, carotid reconstruction was performed with a flow-through chimeric flap based on superficial femoral vessels (15 cm). After resection of the tumor, the flap was used to replace the soft tissue defect (23 × 12 cm). Anteromedial thigh skin paddle (8 × 5 cm) and sartorius muscle (12 × 3 cm) were included in the flap. The superficial femoral vessels were reconstructed with 8-mm ringed polytetrafluoroethylene graft interposition. Thanks to an accurate surgical planning and a 2-team approach, the ischemia time of the leg was 42 min and there were no limb ischemia nor pathologic neurological signs after surgery. During the 12-month follow up, no other complication was registered. In our experience, microsurgical carotid reconstruction represents a reliable option with important advantages such as resistance to infection, optimal size matching, and good tissue healing between the irradiated carotid stump and the vascular graft.