title: True and 'choke' anastomoses between perforator angiosomes: part i. anatomical location.
abstract: BACKGROUND
  Reports of more than two cutaneous perforator angiosome territories being raised successfully in distally based sural flaps are appearing in the literature. Previous anatomical studies have noted that cutaneous arteries, connected by true anastomosis without change in caliber, frequently parallel cutaneous nerves.
  
  
  METHODS
  Twenty-four (48 sides) total body lead oxide cadaver injection studies, including seven arterial and two venous neurovascular, were examined, and the results were compared with clinical thermography in Part II.
  
  
  RESULTS
  Long branches of cutaneous perforators, connected in a series by true anastomoses, paralleled at variable distances the main trunks of cutaneous nerves in the head, neck, torso, and upper and lower extremities. Specifically, in the leg, an average of 3.2 true anastomoses (range, 1 to 5) connected perforators that paralleled the sural nerve on the back of the calf; and 2.5 (range, 1 to 4) connected perforators on the medial side of the leg. These vascular freeways were paralleled by the short and long saphenous veins, respectively.
  
  
  CONCLUSIONS
  True anastomoses frequently connect skin perforators that course in parallel with cutaneous nerves and veins. They provide an explanation for the long viable flaps noted in the leg, and it will be shown in Part II that they can be detected preoperatively with thermography.
authors.affiliation: Parkville, Victoria, Australia From the Department of Anatomy and Neuroscience, University of Melbourne.
authors.forename: G Ian
authors.initials: GI
authors.lastname: Taylor
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Chubb
authors.forename: Mark W
authors.initials: MW
authors.lastname: Ashton
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001132:Arm / Q000033:anatomy & histology / Q000098:blood supply / Q000294:innervation; D001158:Arteries / Q000033:anatomy & histology* / Q000294:innervation; D002102:Cadaver; D006257:Head / Q000033:anatomy & histology / Q000098:blood supply / Q000294:innervation; D006801:Humans; D007866:Leg / Q000033:anatomy & histology / Q000098:blood supply* / Q000294:innervation; D008297:Male; D009333:Neck / Q000033:anatomy & histology / Q000098:blood supply / Q000294:innervation; D061525:Perforator Flap / Q000098:blood supply* / Q000294:innervation*; D011300:Preoperative Care; D011817:Rabbits; D012867:Skin / Q000033:anatomy & histology / Q000098:blood supply* / Q000294:innervation; D040521:Subcutaneous Tissue / Q000033:anatomy & histology / Q000098:blood supply / Q000294:innervation; D013497:Sural Nerve / Q000033:anatomy & histology / Q000098:blood supply*; D013817:Thermography