Archives of Plastic Surgery

  • 제50권6호
  • /
  • Pages.568-572
  • /
  • 2023
  • /
  • 2234-6163(pISSN)
  • /
  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
권호 표지
DOI QR코드

DOI QR Code

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

  • Cyril Awaida (Division of Plastic and Reconstructive Surgery, University of Montreal Hospital Center) ;
  • Marion Aribert (Division of Plastic and Reconstructive Surgery, University of Montreal Hospital Center) ;
  • Natalie Weger (Department of Surgery, University of Iowa Hospitals and Clinics) ;
  • Kendall Keck (Department of Surgery, University of Iowa Hospitals and Clinics) ;
  • Andrei Odobescu (Department of Plastic Surgery, University of Texas-Southwestern)
  • 투고 : 2022.12.29
  • 심사 : 2023.06.27
  • 발행 : 2023.11.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Cutaneous 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.

키워드

참고문헌

  1. Genders RE, Osinga JAJ, Tromp EE, O'Rourke P, Bouwes Bavinck JN, Plasmeijer EI. Metastasis risk of cutaneous squamous cell carcinoma in organ transplant recipients and immunocompetent patients. Acta Derm Venereol 2018;98(06):551-555  https://doi.org/10.2340/00015555-2901
  2. Lanz J, Bouwes Bavinck JN, Westhuis M, et al. Aggressive squamous cell carcinoma in organ transplant recipients. JAMA Dermatol 2019;155(01):66-71  https://doi.org/10.1001/jamadermatol.2018.4406
  3. Abreo K, Sachdeva B, Abreo AP. To ligate or not to ligate hemodialysis arteriovenous fistulas in kidney transplant patients. J Vasc Access 2021;22(06):942-946  https://doi.org/10.1177/1129729820970786
  4. Lucero OM, Echaiz CF, Jafarian F, et al. Keratinocyte carcinomas arising near arteriovenous fistulas: case series and safety considerations for dermatologic surgery: a report of the International Transplant Skin Cancer Collaborative. JAAD Case Rep 2018;5(01):7-11 
  5. Giesen T, Forster N, Kunzi W, Giovanoli P, Calcagni M. Retrograde arterialized free venous flaps for the reconstruction of the hand: review of 14 cases. J Hand Surg Am 2014;39(03):511-523  https://doi.org/10.1016/j.jhsa.2013.12.002
  6. Agarwal P, Kumar A, Sharma D. Feasibility of type III venous flap in coverage of hand defects following trauma and burns. J Clin Orthop Trauma 2016;7(Suppl 2):150-153  https://doi.org/10.1016/j.jcot.2016.11.001
  7. Efanov JI, ElHawary H, Chollet A, Mottard S, Borsuk DE. The pediatric arterialized venous flow-through flap. Plast Reconstr Surg Glob Open 2021;9(03):e3488 
  8. Yu G, Lei HY, Guo S, Huang JH, Yu H. Dorsalis pedis arterialized venous flap for hand and foot reconstruction. Chin J Traumatol 2012;15(01):32-35 
  9. Nath NS, Gilmore BF, McCann RK, Mosca PJ. Management of a cutaneous squamous cell carcinoma overlying an AV fistula. BMJ Case Rep 2017;2017:bcr-2016-218932 
  10. Locke J, Karimpour S, Young G, Lockett MA, Perez CA. Radiotherapy for epithelial skin cancer. Int J Radiat Oncol Biol Phys 2001;51(03):748-755  https://doi.org/10.1016/S0360-3016(01)01656-X
  11. Letachowicz K, Banasik M, Krolicka A, et al. Vascular access perspectives in patients after kidney transplantation. Front Surg 2021;8:640986 
  12. Yaffe HC, Greenstein SM. Should functioning AV fistulas be ligated after renal transplantation? J Vasc Access 2012;13(04):405-408  https://doi.org/10.5301/jva.5000086
  13. Wilmink T, Hollingworth L, Dasgupta I. Access ligation in transplant patients. J Vasc Access 2016;17(1, suppl 1):S64-S68  https://doi.org/10.5301/jva.5000537
  14. Allon M. Vascular access for hemodialysis patients: new data should guide decision making. Clin J Am Soc Nephrol 2019;14(06):954-961  https://doi.org/10.2215/CJN.00490119
  15. Benanti E, De Santis G, Leti Acciaro A, Colzani G, Baccarani A, Starnoni M. Soft tissue coverage of the upper limb: a flap reconstruction overview. Ann Med Surg (Lond) 2020;60:338-343  https://doi.org/10.1016/j.amsu.2020.10.069
  16. Odobescu A. 478 complex burn reconstruction with venous flaps. J Burn Care Res 2019;40(Suppl 1):213-213  https://doi.org/10.1093/jbcr/irz013.372
  17. Roberts JM, Carr LW, Haley CT, Hauck RM, Michelotti BF. Venous flaps for revascularization and soft-tissue coverage in traumatic hand injuries: a systematic review of the literature. J Reconstr Microsurg 2020;36(02):104-109  https://doi.org/10.1055/s-0039-1695053
  18. Yan H, Brooks D, Ladner R, Jackson WD, Gao W, Angel MF. Arterialized venous flaps: a review of the literature. Microsurgery 2010;30(06):472-478  https://doi.org/10.1002/micr.20769
  19. Goldschlager R, Rozen WM, Ting JWC, Leong J. The nomenclature of venous flow-through flaps: updated classification and review of the literature. Microsurgery 2012;32(06):497-501  https://doi.org/10.1002/micr.21965
  20. Rozen WM, Ting JWC, Gilmour RF, Leong J. The arterialized saphenous venous flow-through flap with dual venous drainage. Microsurgery 2012;32(04):281-288 https://doi.org/10.1002/micr.21949