title: Computed Tomography Angiography Allows the Classification of the First Dorsal Metatarsal Arteries.
abstract: BackgroundConventional angiography is an invasive technique. Submillimeter computed tomography angiography (CTA) has been shown to be an effective alternative for peripheral artery branches. This study aimed to assess the use of CTA to guide the choice and design of foot donor area for finger or thumb reconstruction.MethodsThis was a retrospective study of 79 patients who underwent finger or thumb reconstruction between January, 2011 and March, 2014. All these patients underwent preoperative CTA to determine the exact blood supply at the donor site. Preoperative imaging and intraoperative findings at the donor site were compared.ResultsAmong the 79 patients (158 feet), 474 artery segments (dorsalis pedis artery [DPA], first dorsal metatarsal artery [FDMA], and toe web artery [TWA]) were evaluated using CTA. Image satisfaction rates of the vessels were 100.0 ± 0.0%, 89.2 ± 3.2%, and 60.1 ± 5.0% for DPA, FDMA, and TWA, respectively. Among the 158 feet, 90 were Gilbert type I (57.0%), 52 were Gilbert type II (32.9%), 13 were Gilbert type III (8.2%), and 3 were with poor visibility and could not be classified (1.9%). In all 79 patients, the CTA image of the FDMA was consistent with the intraoperative observations. All reconstructed fingers survived. Follow-up was available for 69 patients. After a 6- to 18-month follow-up, the reconstructed fingers and donor area recovered well, and the reconstructed fingers had strong holding power, without pain.ConclusionCTA can produce three-dimensional images for extremity arteries, allowing the preoperative assessment of blood supply and planning of donor site.
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Keqin
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Pingou
authors.initials: P
authors.lastname: Wei
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Luo
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Mo
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Xuquan
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Han
authors.initials: H
authors.lastname: Lin
authors.affiliation: Department of Hand & Foot Microsurgery, Guigang City People's Hospital, Guigang, Guangxi, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Tan
authors.affiliation: Department of Orthopaedic Surgery, Orthopaedic Hand & Upper Extremity Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D000072226:Computed Tomography Angiography; D005260:Female; D005385:Fingers / Q000098:blood supply* / Q000601:surgery; D006230:Hand Injuries / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D013933:Thumb / Q000098:blood supply* / Q000601:surgery; D014034:Toes / Q000098:blood supply; D055815:Young Adult