Prostaglandin E1 has been proven to be useful in the treatment of vascular diseases of the lower leg. Plastic surgeons have been aware of its usefulness in augmenting flap survival and have used it intraarterially or intravenously. We attempted to enhance the effect of prostaglandin E1 with heparin by local continuous intraarterial infusion of both drugs. First, we assessed the viability area of an experimental island flap model on rabbit abdomen, and confirmed the usefulness of this method. Next, we attempted to develop clinical cases using Seldinger's method. By this method, we were able to rescue the flaps with circulatory insufficiency and gain a larger survival area of an axial pattern flap.