Descending Branch of the Lateral Circumflex Femoral Vessels

Abstract

Usually if a recipient site is needed in the thigh or knee region, the conventional choice would be the major femoral or popliteal vessels or a nearby branch. However, if these are compromised or unavailable, or the defect to be reconstructed too lateral to be easily reached, then the descending branch of the lateral circumflex femoral [LCFDB] vessels should be considered as an alternative. Every reconstructive surgeon already is quite familiar with the anterolateral thigh flap and should then readily be able to access this source vessel. If these vessels are proximally based, dependable orthograde inflow and outflow will be achieved. Extending that orientation of the recipient pedicle with interposition vein grafts will allow reach to the knee. To avoid vein grafts, instead the LCFDB can be divided at its origin and based distally such that arterial inflow will depend on retrograde perfusion via the superior lateral genicular collaterals. However, in order to avoid reversed venous outflow and the risk of venous congestion, the greater or lesser saphenous veins should be mobilized to provide the necessary orthograde-directed venous microanastomosis. This is a simple, easily accessible, and straightforward recipient site alternative that should always be a consideration when dealing with lower extremity challenges.