A retrospective study comparing CT angiography and ultrasonic doppler prior to vascularized fibular harvest

doi:10.19438/j.cjoms.2021.03.016

Abstract

Abstract: PURPOSE: This study was aimed to discuss and propose the necessity of selective use of CT angiography(CTA) before vascularized fibular flap harvest. METHODS: A 10-year retrospective analysis was performed to find the patients with various fibular artery(FA) abnormalities confirmed by CTA or intraoperative findings. Different FA abnormalities and their influences on peri- or intra-operative decisions were summarized. RESULTS: A total of 19 FA anomalies were found either pre- or intra-operatively in 16 patients, with 3 cases having bilateral FA anomalies. FA magna was confirmed in 2 legs, while the majority (13 legs) were with type ⅢA hypoplastic/aplastic posterior tibialis arteries, 4 legs with typeⅢD (low bifurcation). Preoperative color doppler ultrasonography(CDU) only suspected anomalies in 2 legs. Six cases proceeded with using the affected fibulas, within whom vascular grafts were used in 3 for lengthening the pedicle of FA. Two cases changed into soft tissue flaps instead of fibular flap intraoperatively. Reconstructive plans changed preoperatively for the other 8 cases, into soft-tissue free flaps, iliac bone flaps or adjacent flaps for 5, 2 and 1 retrospectively. Local ischemia, partial soleus muscle necrosis and claudication was found in 1 patient. CONCLUSIONS: CTA should be performed selectively for screening contraindications for lengthy fibular flaps when necessary.

Key words: Fibular flaps, Fibular artery, Anomaly, CT angiography

CLC Number:

R782.2

MA Chun-yue, TIAN Zhuo-wei, ZHU Dan, QING Xing-jun. A retrospective study comparing CT angiography and ultrasonic doppler prior to vascularized fibular harvest[J]. China Journal of Oral and Maxillofacial Surgery, 2021, 19(3): 262-269.

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