title: Current state of the art in perforator flap imaging with computed tomographic angiography.
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.
authors.affiliation: Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville, VIC, Australia. warrenrozen@hotmail.com
authors.forename: Warren Matthew
authors.initials: WM
authors.lastname: Rozen
authors.forename: Diego
authors.initials: D
authors.lastname: Ribuffo
authors.forename: Matteo
authors.initials: M
authors.lastname: Atzeni
authors.forename: Damien L
authors.initials: DL
authors.lastname: Stella
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
authors.forename: Maristella
authors.initials: M
authors.lastname: Guerra
authors.forename: Damien
authors.initials: D
authors.lastname: Grinsell
authors.forename: Mark W
authors.initials: MW
authors.lastname: Ashton
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D019074:Epigastric Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply*; D014057:Tomography, X-Ray Computed