Computed Tomographic Angiography for Localization of the Cutaneous Perforators of the Leg

Abstract

Statistical analysis demonstrated that the major perforator vessels of the tibial trunk are conserved across individuals and can be reliably dissected using the cluster's statistical distribution. Results of this study will allow for better preoperative planning of local flaps.

Three-Dimensional Computed Tomographic Angiography Study of the Interperforator Flow of the Lower Leg

“…Moreover, as stated by Martin et al, 13 the lack of standardization in reporting results also contributed to such discrepancies. In the current study, the anatomical locations of the perforators were standardized to the leg length and assigned to one of 10 intervals of 0.1 along the standardized leg length, as described by Boriani et al 10 The numbers of perfused perforators were also expressed as a percentage to minimize individual variation.…”

“…Whetzel et al 7 found an average of 4.8 peroneal artery perforators, 3.1 posterior tibial artery perforators, and 9.8 anterior tibial artery perforators per leg, and Schaverien and Saint-Cyr 8 found an average of 4.4 peroneal artery perforators, 4.9 posterior tibial artery perforators, and 9.9 anterior tibial artery perforators per leg. Boriani et al 10 reported that there were 3.7 peroneal artery perforators, 4.1 posterior tibial artery perforators, and 6.3 anterior tibial artery perforators per leg, and Martin et al 13 reported that there were 10.6 peroneal artery perforators, 8.4 posterior tibial artery perforators, and 19 anterior tibial artery perforators per leg. Although the absolute values are different, the anterior tibial artery perforator was the most common perforator in all studies.…”

“…[7][8][9][10][11][12][13][14][15] However, even if we could locate an appropriate perforator accurately, it is not possible to make an exact estimate of the maximum area or width-to-length ratio of a specific perforator.…”

Proximal femur reconstruction using a vascularized fibular epiphysis within a cadaveric femoral allograft in a child with Ewing sarcoma: a case report

“…The epiphysis of the fibula was utilized to give the patient the best chance at continued growth, as previously described in similar procedures [14] . Because the peroneal artery is subject to atherosclerosis in adults, the anterior tibial artery is most often used as the vascular pedicle [15,16] . However, in children, atherosclerosis has typically not yet developed; thus, the peroneal artery is a good option in cases where increased pedicle length is needed.…”

The suprafascial course of lower leg perforators: An anatomical study

“…Perforator flaps in the lower leg mainly originate from the tibialis posterior and peroneal arteries [8]. Preoperative planning to identify perforator vessels is performed via Doppler ultrasonography or computed tomography angiography [9][10][11][12][13][14]. Perforator flaps are designed based on the preoperative imaging results [15].…”