Factor v Leiden associated with flap loss in microsurgical breast reconstruction

Ibrahim Khansa, Salih Colakoglu, David C. Tomich, Minh Doan Nguyen, Bernard T. Lee

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Two cases are reported of flap loss following microsurgical perforator flap breast reconstruction in patients diagnosed with a factor V Leiden mutation. Factor V Leiden is the most common inherited cause of hypercoagulability, leading to an increased risk of thrombotic events. The first patient underwent a deep inferior epigastric artery perforator flap and then had recurrent arterial thrombosis both intraoperatively and postoperatively. This patient was subsequently diagnosed with a factor V Leiden mutation. The second patient had a known factor V Leiden mutation and underwent a superior gluteal artery perforator flap, which developed thrombosis and flap loss 2 days later. Preoperative assessment of a personal or family history of unexplained venous or arterial thrombosis should prompt suspicion of a factor V Leiden mutation. This mutation places patients at high risk for thromboembolic events in microvascular breast reconstruction, particularly when oral contraceptives or tamoxifen are used in conjunction.

Original languageEnglish (US)
Pages (from-to)409-412
Number of pages4
Issue number5
StatePublished - Jul 2011
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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