title: The Role of the Distal Runoff Vessel of the Descending Branch of the Lateral Circumflex Femoral System in Anterolateral Thigh Flap Surgery: A Case Series and Literature Review.
abstract: BACKGROUND
  As a distal portion of the descending branch of the lateral circumflex femoral system (LCFS), the role of the distal runoff vessel in anterolateral thigh (ALT) flap surgery has long been overlooked. Recently, however, the distal runoff vessel has been increasingly used in many aspects of ALT flap surgery, and it has exhibited superior properties in solving some difficult problems.
  
  
  METHODS
  Fourteen ALT flaps using the distal runoff vessel of the descending branch of the LCFS for extremity defects were retrospectively reviewed, and recent reports on using the distal runoff vessel were reviewed to determine the role of this vessel in ALT flap surgery.
  
  
  RESULTS
  In our series, the distal runoff vessel was used as a flow-through pattern in 10 cases, as a recombined chimeric flap in 2 cases, and as a backup vessel for flap salvage in 2 cases. All of the ALT flaps completely survived. None of the donor sites presented with additional morbidity as a result of harvesting the distal runoff vessel. In the literature review, the following are 5 other options for using the distal runoff vessel: in interposition artery and vein grafts, as the pedicle of the reverse-flow ALT flap, as the recipient vessel, to avoid twisting, and as a monitoring method.
  
  
  CONCLUSIONS
  The distal runoff vessel of the descending branch of the LCFS could be used for many aspects of the ALT flap surgery, and this vessel plays an irreplaceable role in some difficult reconstruction surgeries.
authors.affiliation: From *Graduate School, Third Military Medical University, Chongqing; and †Department of Orthopedic Surgery, Kunming General Hospital of Chengdu Military Region, Kunming, People's Republic of China.
authors.forename: Xiao-Qing
authors.initials: XQ
authors.lastname: He
authors.forename: Yue-Liang
authors.initials: YL
authors.lastname: Zhu
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Liang-Bin
authors.initials: LB
authors.lastname: Mei
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.forename: Yong-Qing
authors.initials: YQ
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply* / Q000601:surgery; D013848:Thigh / Q000098:blood supply* / Q000601:surgery; D055815:Young Adult