Preoperative evaluation of lower extremity arteries for free fibula transfer using MDCT angiography.
OBJECTIVE
We discuss the preoperative application of computed tomographic (CT) angiography to identify legs suitable for free fibular flaps.


METHODS
The condition of 118 consecutive patients was prospectively evaluated by means of CT angiography for planned free fibula flap reconstructions. We retrospectively investigated whether fibular free flap transfer was performed in candidate patients and whether the presence of postoperative foot ischemia had been followed.


RESULTS
Multidetector row CT angiography demonstrated a normal arterial anatomy in 82 patients, anatomical variants in 30 patients, and peripheral arterial occlusive disease in 6 patients. The radiologists selected 20 legs as major variants that cannot ensure lower extremity viability after flap harvest. Sixty-three patients underwent fibula free flap transfer. The surgeons followed our imaging diagnosis and selected healthy legs as candidates for fibular free transfer in all but 2 patients. No postoperative foot ischemia presented in any patient.


CONCLUSIONS
Computed tomographic angiography is a reliable preoperative imaging technique for the selection of appropriate legs as candidates for fibular free transfer.
Jin
Kwang Nam
KN
Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea.
Lee
Whal
W
Yin
Yong Hu
YH
Choi
Sang-Il
SI
Jae
Hwan Jun
HJ
Chung
Jin Wook
JW
Park
Jae Hyung
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007472:Iohexol / Q000031:analogs & derivatives; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide