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

 Hyounmin Kim  ;  In-Ho Cha  ;  Hyung Jun Kim  ;  Woong Nam  ;  Hyunwoo Yang  ;  Gibum Shin  ;  Chena Lee  ;  Dongwook Kim 
 JOURNAL OF CLINICAL MEDICINE, Vol.12(12) : 4139, 2023-06 
Journal Title
Issue Date
computed tomography angiography ; perforator flap ; ultrasonography Doppler
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.
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Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Radiology (영상치의학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Wook(김동욱) ORCID logo https://orcid.org/0000-0001-6167-6475
Kim, Hyounmin(김현민)
Kim, Hyung Jun(김형준) ORCID logo https://orcid.org/0000-0001-8247-4004
Nam, Woong(남웅) ORCID logo https://orcid.org/0000-0003-0146-3624
Yang, Hyunwoo(양현우) ORCID logo https://orcid.org/0000-0003-2673-9623
Lee, Chena(이채나) ORCID logo https://orcid.org/0000-0002-8943-4192
Cha, In Ho(차인호) ORCID logo https://orcid.org/0000-0001-8259-2190
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