Objectives/hypothesis: The successful harvest and transplant of a fibular flap depends on many factors, including healthy inflow and outflow systems. A contraindication to harvesting a fibular flap is disease of the lower extremity arterial system; therefore, preoperative evaluation of the arterial system is routine. Preoperative evaluation of the venous system is not routine, unless there is clinical suspicion of venous disease.
Methods: Retrospective chart review.
Results: Two cases of occult deep venous thrombosis (DVT) were encountered intraoperatively resulting in nontransplantable flaps.
Conclusions: This finding represents a serious concern, and we believe that venous imaging should be considered in patients with significant risk factors for harboring an occult DVT. Laryngoscope, 2009.