Free perforator flap for the treatment of defects after resection of huge arteriovenous malformations in the head and neck regions

Isao Koshima, Yuzaburo Nanba, Tetsuya Tsutsui, Yoshio Takahashi, Akira Watanabe, Ryoji Ishii

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

The authors report two cases of huge arteriovenous malformations in the head and neck regions treated successfully with preoperative superselective transarterial embolization and resection followed by a free perforator flap transfer. Based on the authors' previous cases, en block mass resection of the malformation was possible with bleeding of less than 150 ml. The massive defects could be repaired with free perforator flaps using an anterolateral thigh flap and a deep inferior epigastric artery perforator flap. One patient who lost facial muscle underwent reconstruction by simultaneous muscle transfer, and both patients regained acceptable cosmetic appearance and dynamic facial function. Now, more than 4 to 7 years after surgery, the patients have shown no reexpansion of the malformation. The important points of this treatment are complete embolization to accomplish total resection with minimal bleeding, free flap transfer to prevent postoperative reexpansion or recurrence of arteriovenous malformations, and the selection of recipient vessels because of arterial embolization in part of the lesion.

Original languageEnglish
Pages (from-to)194-199
Number of pages6
JournalAnnals of Plastic Surgery
Volume51
Issue number2
DOIs
Publication statusPublished - Aug 1 2003

ASJC Scopus subject areas

  • Surgery

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