Paradoxical venous Doppler signal: a sentinel sign of early venous congestion.
We present a case of early venous congestion in a superior gluteal artery perforator flap for breast reconstruction. The case is unique because the early detection was based on a paradoxical handheld Doppler signal. During reexploration, the vessels were compressed with intermittent obstruction on inspiration. The vessels were repositioned and the flap was salvaged with no further complications. The pathophysiology of this paradoxical sentinel sign is discussed, along with other reasons leading to the outflow obstruction.
Bar-Meir
Eran D
ED
Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Merali
Hasan S
HS
Yueh
Janet H
JH
Tobias
Adam M
AM
Lee
Bernard T
BT
D000714:Anastomosis, Surgical; D001940:Breast / Q000098:blood supply / Q000601:surgery; D002081:Buttocks / Q000098:blood supply*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D016462:Mammaplasty / Q000379:methods*; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply*; D014463:Ultrasonography