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Microvascular distal foot arterialization with flow through free flaps for salvage of the no-option foot

Year: 2025

Type: article

Abstract: Patients with chronic limb-threatening ischemia, advanced foot wounds, and no pedal revascularization targets often face amputation. Deep vein arterialization has significant drawbacks. We report three cases using flow-through free flaps with microvascular distal foot arterialization to salvage ischemic feet with complex wounds. All flaps survived. Patients achieved wound healing and ambulation. Two maintained perfusion at 3 and 6 years. One required transmetatarsal amputation at 14 months but remains ambulatory. This technique provides a novel salvage option for the "no-option" foot by combining soft tissue coverage and selective arterialization of small distal veins, avoiding complications of deep vein arterialization and offering durable perfusion.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2025.101914

Authors: John M. Felder, Emmanuel Nageeb, Vipul Khetarpaul, Ryan Wahidi, Patrick Geraghty

Institutions: Beaumont Health, Beaumont Hospital, Royal Oak, Corewell Health William Beaumont University Hospital, Washington University in St. Louis

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250