Current state of the art in perforator flap imaging with computed tomographic angiography

Rozen, Warren Matthew, Ribuffo, Diego, Atzeni, Matteo, Stella, Damien L., Saba, Luca, Guerra, Maristella, Grinsell, Damien, and Ashton, Mark W. (2009) Current state of the art in perforator flap imaging with computed tomographic angiography. Surgical and Radiologic Anatomy, 31 (8). pp. 631-639.

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Abstract

Computed tomographic angiography (CTA) has become increasingly adopted for preoperative imaging in perforator flap surgery, as it has been shown to improve operative outcomes and decrease operating times prior to deep inferior epigastric artery perforator (DIEP) flap and anterolateral thigh perforator flap surgery. Current technologies are readily available for the preoperative imaging of all perforator flaps, however only sporadic reports of the use of CTA for the imaging of other perforators have been described. We describe our experience with 325 CTAs performed for the preoperative imaging of perforators prior to 370 perforator flaps throughout several body regions. The scanning techniques, software reconstructions and technical issues are explored. In all cases, CTA was scored by the radiologist as at least "sufficient", and described as "optimal" in the majority of cases. Similarly, the surgeon described the correlation of imaging to operative findings as at least "good", and described the correlation as "optimal" in the majority of cases. As such, a standardized protocol for the use of CTA prior to perforator flap surgery is provided, which has been shown to be successful prior to a range of perforator flap operations.

Item ID: 32423
Item Type: Article (Case Study)
ISSN: 1279-8517
Keywords: deep inferior epigastric artery perforator flap; DIEP flap; transverse rectus abdominis; computed tomography angiography; anterolateral thigh flap; preoperative imaging; CT scan
Date Deposited: 29 Apr 2014 00:29
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110320 Radiology and Organ Imaging @ 80%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110399 Clinical Sciences not elsewhere classified @ 20%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 20%
97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 80%
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