Use of Tissue Plasminogen Activator to Salvage a Precious Free Tissue Transfer

Microsurgical free tissue transfer is a technically demanding exercise and requires careful planning and execution.[1] Multiple recent studies have reported success rates ranging from 95 to 98%. With meticulous pre-, intra-, and postoperative care, risk of failure can be minimized though it cannot be eliminated.[1]

The venous system being a low-pressure system is prone to stasis, subsequent thrombosis, and obstruction with minimal variation in flow dynamics or external pressure. Venous compromise is commoner than arterial obstruction among the factors leading to unfavorable outcomes following free tissue transfers.[1]

We are presenting a case of a free fibular osteo-cutaneous flap which was salvaged with an intra-arterial injection of recombinant tissue plasminogen activator (rtPA).

Publication History

Article published online:
26 July 2020

• References

• 1 Koul AR, Patil RK, Nahar S. Unfavourable results in free tissue transfer. Indian J Plast Surg 2013; 46 (02) 247-255
• 2 Jilani TN, Siddiqui AH. Tissue plasminogen activator. In: StatPearls. Treasure Island: Stat Pearls Publishing; 2020 Available at: https://www.ncbi.nlm.nih.gov/books/NBK507917
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