Use of a cross-over arteriovenous fistula for simultaneous microsurgical tissue transfer and restoration of blood flow to the lower extremity

A new microsurgical concept for simultaneous restoration of peripheral perfusion in the lower extremity and microsurgical free-tissue transfer is presented. The concept consists of a contralateral cross-over suprapubic arteriovenous (A-V) fistula, end-to-side anastomoses of the superficial and deep femoral artery to the A-V fistula, and microsurgical flap transfer after division of the A-V loop. With this concept, simultaneous restoration of perfusion and defect reconstruction were facilitated. (C) 2004 Wiley-Liss, Inc.