ABSTRACT
The appearance of a pseudoaneurysm in a free flap is an extremely rare complication
in microsurgery. Yet, although uncommon, this occurrence still poses a dilemma as
to the most effective mode of treatment. Treatment modalities consist of surgical
exploration, embolization, and endovascular stenting. We present a case of arterial
pedicle pseudoaneurysm following free tissue transfer of a radial forearm flap for
a cranial defect. We describe our successful operative treatment of the pseudoaneurysm
as well as review the literature regarding the applicability of the described treatments.
We conclude that a critical evaluation of factors including the timing of arterial
inflow loss, the necessity of the pedicle, the condition and quality of the recipient
site, and the possibility of neovascularization can assist in determining the proper
intervention and maximizing success.
KEYWORDS
Pseudoaneurysm - microvascular anastomosis - free flap complications
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William A ZamboniM.D. F.A.C.S.
Professor and Chairman, Department of Surgery, Chief, Division of Plastic Surgery
2040 West Charleston Boulevard, Suite 301, Las Vegas, NV 89102
