title: Continuous local intraarterial infusion of anticoagulants for microvascular free tissue transfer in primary reconstruction of the lower limb following resection of sarcoma.
abstract: In free tissue transfers, preventing microvascular thrombosis is the first priority to achieve a successful result. Numerous protocols exist for preventing thrombosis postoperatively. We performed continuous local intraarterial infusion of anticoagulants in 11 patients undergoing wide resection of malignant soft tissue tumors, followed by primary microvascular reconstruction in the lower limb. A catheter designed for epidural anesthesia was inserted into the femoral artery and connected to a syringe pump. A daily dose of 100 ml comprising 2,000 U of heparin and 40 microg of prostaglandin E(1) was administered by means of continuous infusion for seven consecutive days as a standard regime. There were no cases of thrombosis during the continuous local intraarterial infusion of anticoagulants. There were no serious systemic complications. Although we have described limited cases and supporting data are lacking, we feel that this procedure might be useful for microsurgical reconstruction of the lower limb.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6, Koto-ku, Tokyo, Japan. megane-31@ima.me-h.ne.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Saito
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sawaizumi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Imai
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsumoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage; D000925:Anticoagulants / Q000008:administration & dosage*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D058752:Free Tissue Flaps; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D007866:Leg; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin; D000527:Alprostadil