Guidelines for the optimization of microsurgery in atherosclerotic patients

Hung Chi Chen, O. Koray Coskunfirat, Ömer Özkan, Samir Mardini, Emanuele Cigna, Christopher J. Salgado, Stefano Spanio

Research output: Contribution to journalReview articlepeer-review

46 Scopus citations


We review the pathogenesis of atherosclerosis and the issues that must be taken into consideration when performing microsurgery in atherosclerotic patients. Atherosclerosis is a systemic disease, and may affect the success of microsurgery. Atherosclerotic patients have a tendency toward thrombosis, because the nature of the arteries is changed. Such patients are usually old and have additional medical problems. To increase the success rate of microsurgery in atherosclerotic patients, special precautions should be considered. Patients must be evaluated properly for the suitability of microsurgery. The microsurgical technique requires a meticulous approach, and various technical tricks can be used to avoid thrombosis. Recipient-vessel selection, anastomotic technique, and the use of vein grafts are all important issues. Prophylactic anticoagulation is recommended in severely atherosclerotic patients. Close monitoring of the patient and flap is necessary after the operation, as with routine microvascular free-tissue transfers. We conclude that atherosclerosis is not a contraindication for microsurgery. If the microsurgeon knows how to deal with the difficulties in atherosclerotic patients, microsurgery can be performed safely.

Original languageEnglish (US)
Pages (from-to)356-362
Number of pages7
Issue number5
StatePublished - Aug 3 2006
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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