title: Preoperative MR angiography for free fibula osteocutaneous flap transfer.
abstract: BACKGROUND
  Magnetic resonance angiography (MRA) is currently considered the most useful test to evaluate the vascular anatomy of the lower leg prior to free fibula osteocutaneous flap transfer. This study aimed to confirm the validity of preoperative MRA.
  
  
  METHODS
  In 19 patients underwent free fibula osteocutaneous flap transfer for maxillary and mandibular reconstruction, the MRA and intraoperative findings and the postoperative complications were retrospectively analyzed. The location and number of distal septocutaneous perforators (dSCPs) that were preoperatively identified and harvested with flaps were documented.
  
  
  RESULTS
  Preoperative MRA detected dSCPs with 100% sensitivity. MRA findings also revealed the diversity of vascular structures, such as the tibio-peroneal bifurcation location and the anatomical relationship between the peroneal vessels and the fibula. No patients suffered postoperative ischemic complications in the donor leg. The total flap survival rate was 95 %.
  
  
  CONCLUSIONS
  Preoperative MRA effectively excluded large vessel anomalies and peripheral vascular disease, and precisely identified the septocutaneous perforators. Additionally, preoperative MRA contributed to a safer fibular osteotomy by predicting the anatomical relationship between the peroneal vessels and the fibula.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. akashim@med.kobe-u.ac.jp
authors.forename: Masaya
authors.initials: M
authors.lastname: Akashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nomura
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sakakibara
authors.forename: Akiko
authors.initials: A
authors.lastname: Sakakibara
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Hashikawa
mesh_terms: D000368:Aged; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D057234:Preoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods