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Lumbar artery perforators: an anatomical study based on computed tomographic angiography imaging
Casper Emile Sommeling1, Britt Colebunders1, Heleen E Pardon1
1a Department of Plastic & Reconstructive Surgery , Ghent University Hospital , Ghent , Belgium.
Acta Chirurgica Belgica
|June 22, 2017
Summary
The lumbar artery perforator flap is a promising option for breast reconstruction. Anatomical study shows perforators consistently emerge 7-10 cm lateral to the midline, simplifying surgical planning.
Area of Science:
- Plastic Surgery
- Anatomy
- Radiology
Background:
- Free lumbar artery perforator flaps offer a novel autologous breast reconstruction option.
- Limited anatomical data exists for the lumbar region as a perforator flap donor site.
Purpose of the Study:
- To anatomically map the dominant lumbar artery perforator for breast reconstruction.
- To determine the precise location of perforators for flap harvesting.
Main Methods:
- Analyzed computed tomographic angiography (CTA) scans of 24 patients undergoing breast reconstruction.
- Identified and mapped 61 dominant lumbar artery perforators using an xy-coordinate system.
Main Results:
- Dominant perforators originate from lumbar arteries at L3 or L4 vertebral levels.
- Approximately 85% of perforators enter the skin 7-10 cm lateral to the midline (mean L: 8.6 cm, R: 8.2 cm).
Conclusions:
- The dominant lumbar artery perforator exhibits a consistent anatomical position.
- Preoperative CTA may not always be necessary; Doppler ultrasound is a potential alternative for perforator localization.
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