{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:34:32Z","timestamp":1773423272699,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patients with chronic limb\u2010threatening ischemia (CLTI) without other options for adequate arterial revascularization could undergo deep (or distal) venous arterialization for limb salvage. Additionally, patients with extensive foot wound with CLTI sometimes require free flap transfer for limb salvage. We herein report a case of successful reconstructive limb\u2010salvage surgery for an extensively necrotic foot with CLTI, using a two\u2010stage operation involving venous arterialization using foot\u2010perforating veins and subsequent free flap transfer (with preservation of the arterialized vein). The patient was a 59\u2010year\u2010old man with CLTI. The patient's right foot had dry necrotic tissue after Lisfranc joint amputation. Only one straight\u2010line to the posterior tibial artery was achieved after endovascular therapies (four times). At the first stage of surgery, an arterial\u2013venous shunt bypass from the superficial femoral artery to the distal great saphenous vein (GSV) (near the foot\u2010perforating vein) was created. Arterial blood supply reached the necrotic area via the foot venous circulation system. At the second stage of surgery, free latissimus dorsi musculocutaneous flap (8\u2009\u00d7\u200927\u2009cm) transfer with preservation of the arterialized vein was performed. The pedicle artery was anastomosed to the bypass graft (end\u2010to\u2010side). The pedicle vein was anastomosed to the proximal stump of the GSV (end\u2010to\u2010end). The flap and residual foot survived completely, at a one\u2010year follow\u2010up postoperatively. An indocyanine green bypass\u2010through angiography revealed the angiosome through the venous arterialization bypass graft, which included the flap; entire forefoot; and partial regions of the midfoot and heel. This two\u2010stage operation might be considered a useful option for limb\u2010salvage and complete wound\u2010healing in patients with severe non\u2010healing wound with CLTI. The two methods could compensate and overcome the problems of either method: incomplete wound\u2010healing after venous arterialization, and the absence of a recipient artery for free flap transfer.<\/jats:p>","DOI":"10.1002\/micr.31001","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T14:32:00Z","timestamp":1671719520000},"page":"166-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Two stages of salvaging an extensively necrotic foot with chronic limb\u2010threatening ischemia by arterialization of great saphenous vein and free latissimus dorsi musculocutaneous flap transfer for wound coverage with the arterialized vein as the recipient vessel: A case report"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3285-5428","authenticated-orcid":false,"given":"Yu","family":"Kagaya","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyorin University Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norihiko","family":"Ohura","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyorin University Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Takatsu Chuo Hospital  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mine","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Kyorin University Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.01.066"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22089"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2010.11.013"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.10.085"},{"key":"e_1_2_5_6_1","first-page":"265","article-title":"Nutrient free flaps with vascular bypasses for extremity salvage in patients with chronic limb ischemia","volume":"55","author":"Horch R. E.","year":"2014","journal-title":"The Journal of Cardiovascular Surgery"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008354"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvscit.2022.05.004"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000009132"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1641712"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.05.012"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dsu.12381"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2009.07.001"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2755"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(96)70018-6"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.31001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.31001","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.31001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T13:52:56Z","timestamp":1692453176000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.31001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,22]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1002\/micr.31001"],"URL":"https:\/\/doi.org\/10.1002\/micr.31001","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,22]]},"assertion":[{"value":"2022-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}