title: Histopathological Differences of the Pedicle Artery in Commonly Used Free Flaps: The Influence of Age, Gender, and Side.
abstract: OBJECTIVE
  The increasing use of vascularized free flaps has increased the demand for a specified flap selection. This study investigated histologic differences in the arterial wall of the pedicle for commonly used free flaps and the effect of age, gender, and anatomic side on these differences.
  
  
  METHODS
  Light microscopic examinations of vessel walls were performed on 245 specimens of the nourishing artery of commonly used free vascularized flaps in preserved cadavers. The peroneal artery (PA), radial artery (RA), inferior epigastric artery (IEA), deep circumflex iliac artery (DCIA), and circumflex scapular artery (CSA) were examined. Differences of histologic changes in the arterial wall and the effect of age, gender, and body side were investigated.
  
  
  RESULTS
  All examined vessel specimens (age range, 62 to 98 yr; mean age, 83 yr; 15 female and 12 male) displayed mostly Class II changes. PA showed the greatest atherosclerotic changes, followed by the RA, IEA, DCIA, and CSA. Age had a meaningful effect on PA and RA. Anatomic side was important for PA and DCIA, whereas gender had a minor influence on vessel condition.
  
  
  CONCLUSIONS
  The vessel wall of different flaps showed different atherosclerotic changes depending on age, anatomic side, and gender. These differences should be considered in flap selection.
authors.affiliation: Deputy Medical Director, Department of Oral and Maxillofacial Surgery, Academic Hospital, University of Göttingen, Klinikum Bremerhaven, Bremerhaven; Medical Faculty, University RWTH Aachen, Aachen, Germany. Electronic address: aghassemi@ukaachen.de.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghassemi
authors.affiliation: Assistant Dentist, Private Dental Office, Berlin, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Köhlen
authors.affiliation: Consultant, Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Till
authors.initials: T
authors.lastname: Braunschweig
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Modabber
authors.affiliation: Professor, Institute of Anatomy, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Prescher
authors.affiliation: Consultant, Department of Plastic and Reconstructive Surgery, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Lloyd
authors.initials: L
authors.lastname: Nanhekhan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000473:pathology*; D050197:Atherosclerosis / Q000473:pathology; D002102:Cadaver; D002114:Calcinosis / Q000473:pathology; D019074:Epigastric Arteries / Q000473:pathology; D005260:Female; D005360:Fibula / Q000098:blood supply; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D007083:Iliac Artery / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D058226:Plaque, Atherosclerotic / Q000473:pathology; D017534:Radial Artery / Q000473:pathology; D012540:Scapula / Q000098:blood supply; D012737:Sex Factors; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology