Use of angioscanning in the surgical planning of perforator flaps in the lower extremities.

This is one of the few studies in the literature to describe angio-computed tomography (CT) as a planning tool in perforator flap surgery in the lower extremities. Eighteen consecutive patients undergoing a perforator flap for lower-extremity reconstruction underwent preoperative CT angiography between September 2007 and November 2009. Eleven received propeller-type flaps, four medial sural artery perforator (MSAP) flaps, two lateral sural artery perforator (LSAP) flaps and one anterolateral thigh (ALT) flap. Preoperative CT angiography was highly specific (100%) and sensitive in mapping and visualising perforators in the lower limb. There were hardly any flap failures after angio-CT, and operative findings always correlated perfectly with preoperative imaging. Postoperative recoveries were uneventful except in three cases of peroneal artery perforator flaps that presented partial necrosis due to venous congestion. CT angiography is a valuable imaging tool for the preoperative assessment of the donor-site vascular supply for lower-extremity flaps. We recommend use of preoperative angio-CT for imaging vascular anatomy of the lower limb before defect reconstruction, especially in traumatic patients and patients with peripheral vascular disease. Its use can also reduce intra-operative dissection time and minimises surgical error in the identification of the vascular anatomy. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Citation

M C Higueras Suñé, A López Ojeda, J A Narváez García, M De Albert De Las Vigo, O Roca Mas, D Perez Sidelnikova, C Carrasco López, J A Palacin Porte, J M Serra Payró, J M Viñals. Use of angioscanning in the surgical planning of perforator flaps in the lower extremities. Journal of plastic, reconstructive & aesthetic surgery : JPRAS. 2011 Sep;64(9):1207-13

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PMID: 21478065

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