Vascular malformations with high–flow lesions remain a challenge in the field of plastic surgery, interventional radiology, and neurosurgery. This is especially true for large lesions requiring a comprehensive team approach.
From March 2001 to December 2004, a total of nine patients with vascular malformations and extensive involvement of the skin underwent selective embolization followed by resection and reconstruction with anterolateral thigh perforator flaps. The ages of patients ranged from 22 to 53 years (average: 32 years) and there were six males and three females. The size of the defect ranged from 8 x 10 cm to 12 x 14 cm. During the follow–up period from 3 months to 41 months, four patients required ancillary procedures to improve their aesthetic appearances. All patients achieved acceptable contour, appearance, and sensation without any incidence of recurrence.
The anterolateral thigh perforator flap provides a large, thin and sensible flap. The anatomy of the flap is relatively constant and reliable. Despite the extensive involvement of arteriovenous malformations of the face, with selective embolization, maximal resection, and coverage with well–vascularized tissue, such malformations can be safely removed and successfully reconstructed.
