Imaging Studies for Preoperative Planning of Perforator Flaps: An Overview.

Area of Science:

• Vascular Surgery
• Radiology
• Anatomy

Background:

• Individual variations in perforator vascular anatomy necessitate precise preoperative assessment for safe perforator flap planning.
• Perforator flaps are crucial in reconstructive surgery, requiring detailed understanding of the underlying vasculature.

Observation:

• Perforator computed tomographic angiography (P-CTA) utilizing multidetector-row computed tomography (MDCT) offers superior 3-dimensional visualization of perforator vessels.
• This advanced imaging modality allows for detailed anatomical mapping of the perforating vessels prior to surgical intervention.

Findings:

• The authors detail their experience employing P-CTA with MDCT for preoperative perforator vessel detection.
• A step-by-step surgical approach for harvesting perforator flaps, guided by P-CTA findings, is presented.
• A comprehensive literature review on alternative preoperative assessment tools for perforators is included.

Implications:

• P-CTA with MDCT provides a reliable method for preoperative assessment, improving the safety and efficacy of perforator flap surgery.
• This technique aids surgeons in selecting optimal perforators and planning flap harvest, potentially reducing complications.
• The findings contribute to the standardization of imaging protocols for perforator flap pre-surgical evaluation.