title: Three-Dimensional Computed Tomographic Angiography Study of the Interperforator Flow of the Lower Leg.
abstract: The area perfused by a single perforator depends on its perforasome and its unique interperforator flow pattern. The purpose of this study was to clarify the interperforator flow patterns of the peroneal and posterior tibial artery perforators using three-dimensional computed tomographic angiography.
  
  
  
  Thirteen whole-leg skin flaps were harvested in the subfascial plane from fresh cadavers. Peroneal, posterior tibial, anterior tibial, and sural artery perforators with a diameter greater than 0.5 mm were documented. Three-dimensional computed tomographic angiography with an injection of iodinated contrast medium into the peroneal or posterior tibial artery perforator was used to investigate the percentages of the area and the perforators that were perfused.
  
  
  
  The mean percentage of the total area perfused was as follows: peroneal artery perforator, 42.0 percent; posterior tibial artery perforator, 38.0 percent (p = 0.084). The mean percentage of the total perforators perfused was as follows: peroneal artery perforator, 55.0 percent; posterior tibial artery perforator, 44.2 percent (p = 0.004). Although the mean percentages of same-source artery perforators perfused by a peroneal artery perforator (73.6 percent) and by a posterior tibial artery perforator (77.2 percent) did not differ (p = 0.513), the mean percentages of other-source artery perforators perfused by a peroneal artery perforator (49.9 percent) and by a posterior tibial artery perforator (32.3 percent) were significantly different (p < 0.001).
  
  
  
  This study demonstrated that a single peroneal or posterior tibial artery perforator perfused approximately 40 percent of the whole leg surface and that peroneal and posterior tibial artery perforators had different interperforator flow patterns. The results of this study may improve preoperative planning for pedicled perforator flap surgery.
  
  
  
  Therapeutic, V.
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Yoo Joon
authors.initials: YJ
authors.lastname: Sur
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Morsy
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Anita T
authors.initials: AT
authors.lastname: Mohan
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Michalak
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Nirusha
authors.initials: N
authors.lastname: Lachman
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Alexis T
authors.initials: AT
authors.lastname: Laungani
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Nick
authors.initials: N
authors.lastname: van Alphen
authors.affiliation: Rochester, Minn.; Uijeongbu, Republic of Korea; Assiut, Egypt; and Beijing, People's Republic of China.|From the Division of Plastic Surgery, Department of Surgery, and the Departments of Radiology and Anatomy, Mayo Clinic; the Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; the Department of Orthopedic Surgery, Assiut University Hospital; Restoration of Appearance and Function Charitable Trust, London, UK; and the Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital.
authors.forename: Michel
authors.initials: M
authors.lastname: Saint-Cyr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008955:Models, Cardiovascular; D061525:Perforator Flap; D016909:Tibial Arteries