Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Utility of Lateral Circumflex Femoral Artery Perforator's 3D Image with MD-CT

MD-CT로 얻은 가쪽넙다리휘돌이 관통동맥 3D 영상의 유용성

  • Park, Soo Ho (Department of Plastic and Reconstructive Surgery school of Medicine, Catholic University of Daegu) ;
  • Shim, Jeong Su (Department of Plastic and Reconstructive Surgery school of Medicine, Catholic University of Daegu) ;
  • Lee, Sang Kon (Department of Radiology, School of Medicine, Catholic University of Daegu) ;
  • Park, Dae Hwan (Department of Plastic and Reconstructive Surgery school of Medicine, Catholic University of Daegu)
  • 박수호 (대구가톨릭대학교 의과대학 성형외과학교실) ;
  • 심정수 (대구가톨릭대학교 의과대학 성형외과학교실) ;
  • 이상곤 (대구가톨릭대학교 의과대학 영상의학과교실) ;
  • 박대환 (대구가톨릭대학교 의과대학 성형외과학교실)
  • Received : 2008.03.31
  • Accepted : 2008.05.02
  • Published : 2008.07.10
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Abstract

Purpose: Currently, using perforator artery flaps especially anterolateral thigh flaps are widely used for reconstruction of extremities, head and neck. Obtaining a precise anatomical picture prior to operation will translate to a more accurate, efficient and safe procedure. Authors used 3D-image work up via 64-slice MDCT to make a more precise preoperative plan. Methods: A total of 10 patients underwent soft tissue reconstruction with anterolateral thigh flap from December 2006 to December 2007. The 64-Channel MDCT (LightSpeed VCT, GE, USA) was used and 3D images were reconstructed. Findings from MDCT were applied to the preoperative planning and confirmed with intraoperative findings. Results: The average number of perforator arteries from lateral circumflex femoral artery was 2. The average lengths of vascular pedicle from the origin of lateral circumflex femoral artery to the first and second perforator artery were 11.0 cm and 20.0 cm, respectively. The average diameter of the pedicle artery was 2.2 mm. The locations of the perforator arteries were mapped and localized on the body surface based on the MDCT result. These were confirmed through direct visualization intraoperatively. Conclusion: MDCT has an advantage of obtaining accurate images of the general anatomy and even fine structures like perforator arteries. By using this state-of-the-art diagnostic imaging technique, it is now possible to make an operative plan safely and easily.

Keywords

References

  1. Geddes CR, Morris SF, Neligan PC: Perforator flaps: evolution, classification, and applications. Ann Plast Surg 50: 90, 2003 https://doi.org/10.1097/00000637-200301000-00016
  2. Song YG, Chen GZ, Song YL: The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 37: 149, 1984 https://doi.org/10.1016/0007-1226(84)90002-X
  3. Yildirim S, Avci G, Akan M, Misirlioğlu A, Akoz T: Anterolateral thigh flap in treatment of postburn flexion contractures of the knee. Plast Reconstr Surg 111: 1630, 2003 https://doi.org/10.1097/01.PRS.0000055017.39339.C2
  4. Valdatta L, Tuinder S, Buoro M, Thione A, Faga A, Putz R: Lateral circumflex femoral arterial system and perforators of the anterolateral thigh flap: an anatomic study. Ann Plast Surg 49: 145, 2002 https://doi.org/10.1097/00000637-200208000-00006
  5. Wei FC, Jain V, Celik N, Chen HC, Chuang CC, Lin CH: Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109: 2219, 2002 https://doi.org/10.1097/00006534-200206000-00007
  6. Kim EK, Hong JP: Sole reconstruction using anterolateral thigh perforator free flaps. J Korean Soc Plast Reconstr Surg 32: 441, 2005
  7. Song HS, Park MC: The regional anatomy of perforating artery and pedicle for the anterolateral thigh free flap in the Korean. J Korean Soc Plast Reconstr Surg 35: 19, 2008
  8. Hallock GG: The preexpanded anterolateral thigh free flap. Ann Plast Surg 53: 170, 2004 https://doi.org/10.1097/01.sap.0000112288.25696.fb
  9. Jeon BJ, Lim SY, Hyon WS, Bang SI, Oh KS, Mun GH: Anterolateral thigh flap: our experiences in head and neck reconstruction. J Korean Soc Plast Reconstr Surg 33: 276, 2006
  10. Kimata Y, Uchiyama K, Ebihara S, Nakatsuka T, Harii K: Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases. Plast Reconstr Surg 102: 1517, 1998 https://doi.org/10.1097/00006534-199810000-00026
  11. Tsukino A, Kurachi K, Inamiya T, Tanigaki T: Preoperative color Doppler assessment in planning of anterolateral thigh flaps. Plast Reconstr Surg 113: 241, 2004 https://doi.org/10.1097/01.PRS.0000095949.41413.88
  12. Alonso-Burgos A, Garcia-Tutor E, Bastarrika G, Cano D, Martinez-Cuesta A, Pina LJ: Preoperative planning of deep inferior epigastric artery perforator flap reconstruction with multislice-CT angiography: imaging findings and initial experience. J Plast Reconstr Aesthet Surg 59: 585, 2006 https://doi.org/10.1016/j.bjps.2005.12.011
  13. Chang H, Heo C, Jeong J, Baek R, Minn K, Yoon C: Unilateral buttock reconstruction using contralateral inferior gluteal artery perforator flap with the aid of multi-detector CT. J Plast Reconstr Aesthet Surg 14: (Epub ahead of print), 2007
  14. Jin KN, Lee W, Yin YH, Choi SI, Jae HJ, Chung JW, Park JH: Preoperative evaluation of lower extremity arteries for free fibula transfer using MDCT angiography. J Comput Assist Tomogr 31: 820, 2007 https://doi.org/10.1097/RCT.0b013e318033defd