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...
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| Format: | Article |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/12/4139 |
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| author | Hyounmin Kim In-ho Cha Hyung Jun Kim Woong Nam Hyunwoo Yang Gibum Shin Chena Lee Dongwook Kim |
| author_facet | Hyounmin Kim In-ho Cha Hyung Jun Kim Woong Nam Hyunwoo Yang Gibum Shin Chena Lee Dongwook Kim |
| author_sort | Hyounmin Kim |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T02:18:40Z |
| format | Article |
| id | doaj.art-ababccd8f0724492ad318dc25c418276 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T02:18:40Z |
| publishDate | 2023-06-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-ababccd8f0724492ad318dc25c4182762023-11-18T11:01:31ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011212413910.3390/jcm12124139Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate?Hyounmin Kim0In-ho Cha1Hyung Jun Kim2Woong Nam3Hyunwoo Yang4Gibum Shin5Chena Lee6Dongwook Kim7Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaDepartment of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 03722, Republic of KoreaBackground: 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.https://www.mdpi.com/2077-0383/12/12/4139perforator flapcomputed tomography angiographyultrasonography Doppler |
| spellingShingle | Hyounmin Kim In-ho Cha Hyung Jun Kim Woong Nam Hyunwoo Yang Gibum Shin Chena Lee Dongwook Kim Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate? Journal of Clinical Medicine perforator flap computed tomography angiography ultrasonography Doppler |
| title | Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate? |
| title_full | Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate? |
| title_fullStr | Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate? |
| title_full_unstemmed | Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate? |
| title_short | Perforators Detected in Computed Tomography Angiography for Anterolateral Thigh Free Flap: Am I the Only One Who Feels Inaccurate? |
| title_sort | perforators detected in computed tomography angiography for anterolateral thigh free flap am i the only one who feels inaccurate |
| topic | perforator flap computed tomography angiography ultrasonography Doppler |
| url | https://www.mdpi.com/2077-0383/12/12/4139 |
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