TY - JOUR
T1 - Three-Dimensional Computed Tomographic Angiography Study of the Interperforator Flow of the Lower Leg
AU - Sur, Yoo Joon
AU - Morsy, Mohamed
AU - Mohan, Anita T.
AU - Zhu, Lin
AU - Michalak, Gregory J.
AU - Lachman, Nirusha
AU - Laungani, Alexis T.
AU - Van Alphen, Nick
AU - Saint-Cyr, Michel
N1 - Publisher Copyright:
© 2016 by the American Society of Plastic Surgeons.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Background: The area perfused by a single perforator depends on its perforasome and its unique interperforator flow pattern. The purpose of this study was to clarify the interperforator flow patterns of the peroneal and posterior tibial artery perforators using three-dimensional computed tomographic angiography. Methods: Thirteen whole-leg skin flaps were harvested in the subfascial plane from fresh cadavers. Peroneal, posterior tibial, anterior tibial, and sural artery perforators with a diameter greater than 0.5 mm were documented. Three-dimensional computed tomographic angiography with an injection of iodinated contrast medium into the peroneal or posterior tibial artery perforator was used to investigate the percentages of the area and the perforators that were perfused. Results: The mean percentage of the total area perfused was as follows: peroneal artery perforator, 42.0 percent; posterior tibial artery perforator, 38.0 percent (p = 0.084). The mean percentage of the total perforators perfused was as follows: peroneal artery perforator, 55.0 percent; posterior tibial artery perforator, 44.2 percent (p = 0.004). Although the mean percentages of same-source artery perforators perfused by a peroneal artery perforator (73.6 percent) and by a posterior tibial artery perforator (77.2 percent) did not differ (p = 0.513), the mean percentages of other-source artery perforators perfused by a peroneal artery perforator (49.9 percent) and by a posterior tibial artery perforator (32.3 percent) were significantly different (p < 0.001). Conclusions: This study demonstrated that a single peroneal or posterior tibial artery perforator perfused approximately 40 percent of the whole leg surface and that peroneal and posterior tibial artery perforators had different interperforator flow patterns. The results of this study may improve preoperative planning for pedicled perforator flap surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
AB - Background: The area perfused by a single perforator depends on its perforasome and its unique interperforator flow pattern. The purpose of this study was to clarify the interperforator flow patterns of the peroneal and posterior tibial artery perforators using three-dimensional computed tomographic angiography. Methods: Thirteen whole-leg skin flaps were harvested in the subfascial plane from fresh cadavers. Peroneal, posterior tibial, anterior tibial, and sural artery perforators with a diameter greater than 0.5 mm were documented. Three-dimensional computed tomographic angiography with an injection of iodinated contrast medium into the peroneal or posterior tibial artery perforator was used to investigate the percentages of the area and the perforators that were perfused. Results: The mean percentage of the total area perfused was as follows: peroneal artery perforator, 42.0 percent; posterior tibial artery perforator, 38.0 percent (p = 0.084). The mean percentage of the total perforators perfused was as follows: peroneal artery perforator, 55.0 percent; posterior tibial artery perforator, 44.2 percent (p = 0.004). Although the mean percentages of same-source artery perforators perfused by a peroneal artery perforator (73.6 percent) and by a posterior tibial artery perforator (77.2 percent) did not differ (p = 0.513), the mean percentages of other-source artery perforators perfused by a peroneal artery perforator (49.9 percent) and by a posterior tibial artery perforator (32.3 percent) were significantly different (p < 0.001). Conclusions: This study demonstrated that a single peroneal or posterior tibial artery perforator perfused approximately 40 percent of the whole leg surface and that peroneal and posterior tibial artery perforators had different interperforator flow patterns. The results of this study may improve preoperative planning for pedicled perforator flap surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
UR - http://www.scopus.com/inward/record.url?scp=84954557782&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84954557782&partnerID=8YFLogxK
U2 - 10.1097/PRS.0000000000002111
DO - 10.1097/PRS.0000000000002111
M3 - Article
C2 - 26796376
AN - SCOPUS:84954557782
SN - 0032-1052
VL - 137
SP - 1615
EP - 1628
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 5
ER -