title: Peroneal artery-vein index as a potential factor of thrombosis occurrence in free osteocutaneous fibula flap.
abstract: BACKGROUND
  Despite high popularity and great success rates of free osteocutaneous fibula flaps, the flap failure caused by vascular thrombosis is still a challenging problem. The authors present their evaluation of a potential thrombosis risk factor - a peroneal artery-vein index.
  
  
  METHODS
  The authors evaluated the diameters of peroneal vessels and peroneal artery-vein indexes based on the computed tomography angiographies in 10 patients who underwent a mandible reconstruction with a free fibula flap and compared the results with clinical outcome.
  
  
  RESULTS
  In one case the flap was lost, because of thrombosis in the donor vein. This patient presented superficial varicose veins of both lower extremities. Peroneal vein diameters in this patient ranged from 5,05 mm to 6,68 mm and were higher than in patients without complications. The peroneal artery-vein index in the patient with thrombosis ranged from 0,37 to 0,50 with median 0,40 and was lower than in patients without complications.
  
  
  CONCLUSIONS
  High disproportion between peroneal artery and concomitant veins might be a potential risk factor of the occurrence of venal thrombosis. Detailed perioperative examination of peroneal veins in patients with varicosities should be considered.
authors: Department of Maxillofacial and Plastic Surgery, Medical University of Bialystok, M. C. Sklodowskiej 24a, Bialystok 15-276, Poland.
authors: Dorota
authors: D
authors: Dziemianczyk-Pakiela
authors: Department of Maxillofacial and Plastic Surgery, Medical University of Bialystok, M. C. Sklodowskiej 24a, Bialystok 15-276, Poland. Electronic address: dawidgroth@gmail.com.
authors: Dawid
authors: D
authors: Groth
authors: Department of Maxillofacial and Plastic Surgery, Medical University of Bialystok, M. C. Sklodowskiej 24a, Bialystok 15-276, Poland.
authors: Natalia
authors: N
authors: Toloczko-Iwaniuk
authors: Department of Maxillofacial and Plastic Surgery, Medical University of Bialystok, M. C. Sklodowskiej 24a, Bialystok 15-276, Poland.
authors: Jozef S
authors: JS
authors: Rybak
authors: Department of Maxillofacial and Plastic Surgery, Medical University of Bialystok, M. C. Sklodowskiej 24a, Bialystok 15-276, Poland.
authors: Leszek
authors: L
authors: Piotrowski
authors: Department of Radiology, Medical University of Bialystok, M. C. Sklodowskiej 24a, Bialystok 15-276, Poland.
authors: Adam
authors: A
authors: Lukasiewicz
authors: Department of Maxillofacial and Plastic Surgery, Medical University of Bialystok, M. C. Sklodowskiej 24a, Bialystok 15-276, Poland.
authors: Jan
authors: J
authors: Borys
authors: Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
authors: Tobias
authors: T
authors: Ettl
mesh_terms: D000714:Anastomosis, Surgical; D016025:Bone Transplantation; D000072226:Computed Tomography Angiography; D005260:Female; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation*; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation*; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012307:Risk Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: Free osteocutaneous fibula flap; Microsurgery; Peroneal artery-vein index; Thrombosis; Varicose veins; Varicosities