title: Iatrogenic pseudoaneurysm following reverse radial forearm free tissue transfer.
abstract: The appearance of a pseudoaneurysm in a free flap is an extremely rare complication in microsurgery. Yet, although uncommon, this occurrence still poses a dilemma as to the most effective mode of treatment. Treatment modalities consist of surgical exploration, embolization, and endovascular stenting. We present a case of arterial pedicle pseudoaneurysm following free tissue transfer of a radial forearm flap for a cranial defect. We describe our successful operative treatment of the pseudoaneurysm as well as review the literature regarding the applicability of the described treatments. We conclude that a critical evaluation of factors including the timing of arterial inflow loss, the necessity of the pedicle, the condition and quality of the recipient site, and the possibility of neovascularization can assist in determining the proper intervention and maximizing success.
authors.affiliation: Division of Plastic Surgery, University of Nevada School of Medicine, Las Vegas 89102, USA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Baynosa
authors.forename: Anthony
authors.initials: A
authors.lastname: Echo
authors.forename: Raffi V
authors.initials: RV
authors.lastname: Hovsepian
authors.forename: William A
authors.initials: WA
authors.lastname: Zamboni
mesh_terms: D017541:Aneurysm, False / Q000209:etiology*; D005260:Female; D005542:Forearm / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D007049:Iatrogenic Disease; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D012535:Scalp / Q000293:injuries / Q000601:surgery; D016038:Skin Transplantation / Q000009:adverse effects*; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply*