Use of vein loops in reconstructive procedures.

The use of a temporary arteriovenous fistula prior to flap harvesting was suggested by Threlfall in 1982 (Threlfall, Aust NZ J Surg 52:182-184, 1982). The basic idea is to use long venous grafts that can be branched side-to-end to a main artery at an easily accessible level using one of the well-established exposures from general vascular surgery. In reconstructive microsurgery, AV-loops are used in limb salvage procedures and in cancer surgery. These patients have often undergone previous surgery and additional radiotherapy. AV-loops facilitate the use of normal recipient vessels out of the zone of injury, or far away from scar or irradiated tissue.