Developments in perforator imaging for the anterolateral thigh flap: CT angiography and CT-guided stereotaxy
Introduction: The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always present, vary in size and intramuscular course, and have variable cutaneous courses and supply. As such, preoperative imaging has beco...
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Published in | Microsurgery Vol. 28; no. 4; pp. 227 - 232 |
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Abstract | Introduction: The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always present, vary in size and intramuscular course, and have variable cutaneous courses and supply. As such, preoperative imaging has become favored. Methods: The current study describes the preliminary use of two new modalities for preoperative imaging: computed tomography (CT) Angiography and CT‐guided stereotaxy. These have been utilized in the preoperative imaging of two patients undergoing ALT flap reconstruction. Each patient underwent each of these techniques combined with Doppler ultrasound, the previous standard modality. The size, location, and course of perforators were explored and compared with operative findings. Results: Both techniques are technically feasible, highly accurate, and provide more information to the surgeon than ultrasound. Conclusion: CT Angiography and CT‐guided stereotaxy are useful adjuncts to Doppler ultrasound for imaging perforators prior to ALT flaps. A larger study is suggested to quantify the accuracy of these techniques. © 2008 Wiley‐Liss, Inc. Microsurgery, 2008. |
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AbstractList | The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always present, vary in size and intramuscular course, and have variable cutaneous courses and supply. As such, preoperative imaging has become favored.
The current study describes the preliminary use of two new modalities for preoperative imaging: computed tomography (CT) Angiography and CT-guided stereotaxy. These have been utilized in the preoperative imaging of two patients undergoing ALT flap reconstruction. Each patient underwent each of these techniques combined with Doppler ultrasound, the previous standard modality. The size, location, and course of perforators were explored and compared with operative findings.
Both techniques are technically feasible, highly accurate, and provide more information to the surgeon than ultrasound.
CT Angiography and CT-guided stereotaxy are useful adjuncts to Doppler ultrasound for imaging perforators prior to ALT flaps. A larger study is suggested to quantify the accuracy of these techniques. Abstract Introduction: The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always present, vary in size and intramuscular course, and have variable cutaneous courses and supply. As such, preoperative imaging has become favored. Methods: The current study describes the preliminary use of two new modalities for preoperative imaging: computed tomography (CT) Angiography and CT‐guided stereotaxy. These have been utilized in the preoperative imaging of two patients undergoing ALT flap reconstruction. Each patient underwent each of these techniques combined with Doppler ultrasound, the previous standard modality. The size, location, and course of perforators were explored and compared with operative findings. Results: Both techniques are technically feasible, highly accurate, and provide more information to the surgeon than ultrasound. Conclusion: CT Angiography and CT‐guided stereotaxy are useful adjuncts to Doppler ultrasound for imaging perforators prior to ALT flaps. A larger study is suggested to quantify the accuracy of these techniques. © 2008 Wiley‐Liss, Inc. Microsurgery, 2008. INTRODUCTIONThe anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always present, vary in size and intramuscular course, and have variable cutaneous courses and supply. As such, preoperative imaging has become favored.METHODSThe current study describes the preliminary use of two new modalities for preoperative imaging: computed tomography (CT) Angiography and CT-guided stereotaxy. These have been utilized in the preoperative imaging of two patients undergoing ALT flap reconstruction. Each patient underwent each of these techniques combined with Doppler ultrasound, the previous standard modality. The size, location, and course of perforators were explored and compared with operative findings.RESULTSBoth techniques are technically feasible, highly accurate, and provide more information to the surgeon than ultrasound.CONCLUSIONCT Angiography and CT-guided stereotaxy are useful adjuncts to Doppler ultrasound for imaging perforators prior to ALT flaps. A larger study is suggested to quantify the accuracy of these techniques. Introduction: The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always present, vary in size and intramuscular course, and have variable cutaneous courses and supply. As such, preoperative imaging has become favored. Methods: The current study describes the preliminary use of two new modalities for preoperative imaging: computed tomography (CT) Angiography and CT‐guided stereotaxy. These have been utilized in the preoperative imaging of two patients undergoing ALT flap reconstruction. Each patient underwent each of these techniques combined with Doppler ultrasound, the previous standard modality. The size, location, and course of perforators were explored and compared with operative findings. Results: Both techniques are technically feasible, highly accurate, and provide more information to the surgeon than ultrasound. Conclusion: CT Angiography and CT‐guided stereotaxy are useful adjuncts to Doppler ultrasound for imaging perforators prior to ALT flaps. A larger study is suggested to quantify the accuracy of these techniques. © 2008 Wiley‐Liss, Inc. Microsurgery, 2008. |
Author | Phillips, T. J. Stella, D. L. White, D. C. Taylor, G. I. Ashton, M. W. Rozen, W. M. Ferris, S. |
Author_xml | – sequence: 1 givenname: W. M. surname: Rozen fullname: Rozen, W. M. email: warrenrozen@hotmail.com organization: Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria, Australia – sequence: 2 givenname: M. W. surname: Ashton fullname: Ashton, M. W. organization: Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria, Australia – sequence: 3 givenname: D. L. surname: Stella fullname: Stella, D. L. organization: Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia – sequence: 4 givenname: S. surname: Ferris fullname: Ferris, S. organization: Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria, Australia – sequence: 5 givenname: D. C. surname: White fullname: White, D. C. organization: Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria, Australia – sequence: 6 givenname: T. J. surname: Phillips fullname: Phillips, T. J. organization: Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia – sequence: 7 givenname: G. I. surname: Taylor fullname: Taylor, G. I. organization: Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, Victoria, Australia |
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References_xml | – article-title: A new imaging modality for free flaps in breast reconstruction: CT Angiography publication-title: Plast Reconstr Surg – volume: 121 start-page: 9 issue: 1 year: 2008 end-page: 16 article-title: Preoperative imaging for DIEA perforator flaps: A comparison of CT angiography and Doppler ultrasound publication-title: Plast Reconstr Surg – volume: 59 start-page: 594 year: 2006 end-page: 599 article-title: Multidetector‐row computed tomography in the planning of abdominal perforator flaps publication-title: J Plast Reconstr Aesthet Surg – volume: 56 start-page: 21 year: 2003 end-page: 25 article-title: Preoperative assessment of anterolateral thigh flap cutaneous perforators by colour Doppler flowmetry publication-title: Br J Plast Surg – volume: 118 start-page: 934 year: 2006 end-page: 935 article-title: Efficacy of the handheld Doppler in preoperative identification of the cutaneous perforators in the anterolateral thigh flap publication-title: Plast Reconstr Surg – volume: 119 start-page: 2328 year: 2007 end-page: 2329 article-title: Is there any need to localize the perforator of the anterolateral thigh flap? publication-title: Plast Reconst Surg – volume: 113 start-page: 241 year: 2004 end-page: 246 article-title: Preoperative color Doppler assessment in planning of anterolateral thigh flaps publication-title: Plast Reconstr Surg – volume: 21 start-page: 451 year: 2005 end-page: 452 article-title: Microdissection thinning of a pedicled deep inferior epigastric perforator flap for burn scar contracture of the groin: Case report publication-title: J Reconstr Microsurg – volume: 102 start-page: 1517 year: 1998 end-page: 1523 article-title: Anatomic variations and technical problems of the anterolateral thigh flap: A report of 74 cases publication-title: Plast Reconstr Surg – volume: 59 start-page: 585 year: 2006 end-page: 593 article-title: Preoperative planning of deep inferior epigastric artery perforator flap reconstruction with multi‐slice‐CT angiography: Imaging findings and initial experience publication-title: J Plast Reconstr Aesthet Surg – volume: 118 start-page: 928 year: 2006 end-page: 933 article-title: Efficacy of the handheld Doppler in preoperative identification of the cutaneous perforators in the anterolateral thigh flap publication-title: Plast Reconstr Surg – article-title: Stereotactic image‐guided navigation in the preoperative imaging of perforators for DIEP flap breast reconstruction publication-title: Plast Reconstr Surg – volume: 119 start-page: 2329 year: 2007 end-page: 2330 article-title: Is there any need to localize the perforator of the anterolateral thigh flap? publication-title: Plast Reconst Surg – volume: 121 start-page: 9 issue: 1 year: 2008 ident: e_1_2_1_8_2 article-title: Preoperative imaging for DIEA perforator flaps: A comparison of CT angiography and Doppler ultrasound publication-title: Plast Reconstr Surg contributor: fullname: Rozen WM – ident: e_1_2_1_9_2 article-title: A new imaging modality for free flaps in breast reconstruction: CT Angiography publication-title: Plast Reconstr Surg contributor: fullname: Rozen WM – ident: e_1_2_1_11_2 doi: 10.1016/j.bjps.2005.10.024 – ident: e_1_2_1_7_2 doi: 10.1016/S0007-1226(03)00018-3 – ident: e_1_2_1_12_2 article-title: Stereotactic image‐guided navigation in the preoperative imaging of perforators for DIEP flap breast reconstruction publication-title: Plast Reconstr Surg contributor: fullname: Rozen WM – ident: e_1_2_1_5_2 doi: 10.1097/01.prs.0000261089.60877.ae – ident: e_1_2_1_6_2 doi: 10.1097/01.PRS.0000095949.41413.88 – ident: e_1_2_1_14_2 doi: 10.1097/00006534-199810000-00026 – ident: e_1_2_1_4_2 doi: 10.1097/01.prs.0000261088.08288.29 – ident: e_1_2_1_10_2 doi: 10.1016/j.bjps.2005.12.011 – ident: e_1_2_1_13_2 doi: 10.1055/s-2005-918898 – ident: e_1_2_1_3_2 doi: 10.1097/01.prs.0000232217.14710.a0 – ident: e_1_2_1_2_2 doi: 10.1097/01.prs.0000232216.34854.63 |
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Snippet | Introduction: The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not... The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not always... Abstract Introduction: The anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators... INTRODUCTIONThe anterolateral thigh flap is an increasingly popular reconstructive option despite uncertainty in its perforator anatomy. Perforators are not... |
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SubjectTerms | Adult Angiography - methods Female Humans Male Reconstructive Surgical Procedures - instrumentation Reconstructive Surgical Procedures - methods Surgical Flaps - blood supply Thigh - blood supply Thigh - diagnostic imaging Thigh - surgery Tomography, X-Ray Computed - instrumentation Ultrasonography, Doppler |
Title | Developments in perforator imaging for the anterolateral thigh flap: CT angiography and CT-guided stereotaxy |
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