Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap : Am I the Only One Who Feels Inaccurate?

BACKGROUND: The number, location, and pattern of perforators in anterolateral thigh(ALT) flap vary and predicting them preoperatively will aid in reconstructing complex head and neck defects. This article suggests guidelines for utilizing CTA imagery to predict perforators of ALT-free flaps.

METHODS: We retrospectively analyzed 53 Korean patients who underwent reconstruction with ALT flap in our department from March 2021 to July 2022. The location, course, origin, and pedicle lengths predicted in CTA and confirmed in the operation field were recorded and compared.

RESULTS: Among the 85 intraoperatively-found perforators, 79 were also identified in CTA. Six perforators unidentified in CTA were newly found intraoperatively. The positive predictive value of CTA for the perforator was 100%, with a sensitivity of 79/85 = 92.9%. Of the 79 perforators depicted by the CTA for the flap, CTA and intraoperative findings for the course were consistent in 52 cases, a 9.6 mm median discrepancy being noted between the actual location and CTA.

CONCLUSIONS: The overall pattern or location of perforation was not significantly different between the two, although some differences were observed. It is suggested that the addition of Doppler imaging, in conjunction with CTA, can aid in perforator detection and help minimize such discrepancies.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:12

Enthalten in:

Journal of clinical medicine - 12(2023), 12 vom: 20. Juni

Sprache:

Englisch

Beteiligte Personen:

Kim, Hyounmin [VerfasserIn]
Cha, In-Ho [VerfasserIn]
Kim, Hyung Jun [VerfasserIn]
Nam, Woong [VerfasserIn]
Yang, Hyunwoo [VerfasserIn]
Shin, Gibum [VerfasserIn]
Lee, Chena [VerfasserIn]
Kim, Dongwook [VerfasserIn]

Links:

Volltext

Themen:

Computed tomography angiography
Journal Article
Perforator flap
Ultrasonography Doppler

Anmerkungen:

Date Revised 01.07.2023

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.3390/jcm12124139

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM358751446