[Problems with vascular end-to-end anastomoses].

Despite accurate preoperative investigation of the vessels of the lower part of the leg using angiography and plethysmography as a preparation for a free latissimus dorsi myocutaneous flap, problems can appear at the anastomosis during the operation. In the reported case using a free latissimus dorsi myocutaneous flap for coverage of a tissue defect at the lower leg, thrombosis appeared due to a difference between the calibers of the vein graft and the thoraco-dorsal artery. The existing difference of the calibers was therefore equalized by controlled narrowing of the vein graft. Thereby patency of the anastomosis was achieved and circulation in the free flap was guaranteed.