Preoperative detection of perforator vessels in the perforator flap planning is an actual problem in clinical practice. There are various methods to visualize the localization of perforator vessels. This review presents the main of these methods with a description of their capabilities, advantages and limitations, as well as describes the priorities for using one or another approach depending on the localization of the donor site.

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In this work a comparative analysis of the possibilities and efficiency of lower extremities perforator vessels visualization using the methods of Doppler ultrasound (DUS) and computed tomographic angiography (CTA) is carried out. As a result, it is shown that DUS has a number of advantages over CTA, allowing to obtain a clearer image of perforator vessels, to determine the exact location of their anatomical localization.

The study describes a clinical case of preoperative planning of an anterolateral femur perforator flap and a peroneal autograft to eliminate a maxillofacial defect. During preparation for the surgery, an anatomical feature of the structure of both extremities circulatory system was found, which did not allow full use of the donor area tissues for subsequent surgical intervention. This feature was identified by Doppler ultrasound, but the final picture became clear only due to the study by computed tomography angiography.