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© 2020 by the United states Institute of Ultrasound in Medicine.BACKGROUND complimentary structure transfer for lower limb reconstruction became a workhorse process of limb-salvage. Weighed against various other individual websites, the lower extremity has an increased risk of microvascular problems, in certain with venous anastomosis. The study's objective is to evaluate the proof, safety, and efficacy of venous coupler use in microsurgical anastomosis in lower limb reconstruction to supply unbiased assessment