Open Access
CC BY 4.0 · Arch Plast Surg 2023; 50(03): 311-314
DOI: 10.1055/s-0043-1764309
Extremity/Lymphedema
Case Report

Mechanical Dilation of the Recipient Vessel with the DeBakey Vascular Dilator in Lower Extremity Reconstruction: A Report of Two Cases

Min-Gi Seo 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea
,
Tae-Gon Kim 
1   Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea
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Abstract

In lower extremity reconstruction, the recipient vessel often requires long-range mechanical dilation because of extensive vasospasm or plaque formation induced by concomitant atherosclerosis. While a forceps dilator can be used to manipulate and dilate vessels approximately 1 cm from their end, a DeBakey vascular dilator can dilate long-range vessels. The authors successfully performed free flap reconstruction of the lower extremity using the DeBakey vascular dilator. Of the two patients who underwent lower extremity reconstruction, one had extensive vasospasm, and the other had plaques in the recipient arteries. Irrigation with 4% lidocaine and dilation of the lumen with a forceps dilator were insufficient to restore the normal arterial blood flow. Instead, a DeBakey vascular dilator with a 1-mm diameter tip was gently inserted into the lumen. Then, to overcome vessel resistance, the dilator gently advanced approximately 10 cm to dilate the recipient artery. Normal arterial blood flow was gushed out after dilating the vessel lumen using a DeBakey vascular dilator. The vascular anastomosis was performed, and intravenous heparin 5000 IU was administered immediately after anastomosis. Prophylactic low-molecular-weight-heparin (Clexane, 1 mg/kg) was administered subcutaneously to both patients for 14 days. The reconstructed flap survived without necrosis in either patient.

Keywords

DeBakey vascular dilator - recipient vessel - lower extremity reconstruction - vasospasm - atherosclerosis

Authors' Contributions

All authors contributed to the case conception and design; T.-G. K provided the valuable case and performed the operation; data collection and analysis were performed by M.-G. S.; the first draft of the manuscript was written by M.-G. S.; all authors commented on previous versions of the manuscript; all authors read and approved the final manuscript.


Ethical Approval

This study was study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and approved by the Institutional Review Board of Yeungnam University Hospital (No. 2022-09-041: the registration number of the ethics board).


Patient Consent

The patients' consent was obtained for their clinical photographs for academic purposes.




Publication History

Received: 26 October 2022

Accepted: 13 January 2023

Article published online:
29 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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