A Case Report of Aberrant Vascular Anatomy of the Anterolateral Thigh Flap

Soft tissue free flaps are used for a variety of head and neck reconstructions. The anterolateral thigh (ALT) flap has been a versatile tool in head and neck reconstruction since the mainstream use of microvascular anastomosis for free tissue transfer. The ALT flap has a known history of variable vascular anatomy. Most of this variability lies within perforator anatomy and vascular aberrations distal to the lateral circumflex femoral artery (LCF). Few vascular aberrancies have been described proximal to the LCF. Here we present a case of report of an ALT whose arterial vascular pedicle was a branch directly off the femoral artery. The case highlights an unusual anatomical variant of the ALT flap, and the importance of a thorough and meticulous dissection.