Schuderer, J. G. and Meier, J. K. and Klingelhoeffer, C. and Gottsauner, M. and Reichert, T. E. and Wendl, C. M. and Ettl, T. (2020) Magnetic resonance angiography for free fibula harvest: anatomy and perforator mapping. INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 49 (2). pp. 176-182. ISSN 0901-5027, 1399-0020
Full text not available from this repository. (Request a copy)Abstract
The purpose of this study was to outline lower leg vessel anatomy and to investigate reliability and limitations of magnetic resonance angiography (MRA) in patients proposed for microvascular fibula transplantation (free fibula flap (FFF)). We retrospectively investigated MRAs of 99 patients considered for FFF. Frontal MRA planes and maximal intensity projections (MIPs) were evaluated for fibula lengths, anatomical branching pattern, arterial stenoses and fibular perforator positions in both legs (n = 198). Normal branching patterns were observed in 168 (85.3%) legs. Twenty-nine (14.7%) legs presented abnormal branching patterns. Once (0.5%) the anterior, 19 times (9.6%) the posterior tibial artery were absent or hypoplastic. Nine (4.6%) lower legs presented an arteria peronea magna. Average length of the tibiofibular trunk (TFT) was 3.3 +/- 0.15 cm. A total of 492 perforators were found with an average of 2.5 (+/- 0.82 +/- 0.99) perforators per leg. A mapping of perforator run-offs was illustrated true to scale. Lower limb stenoses were distributed in the anterior tibial artery (14.1%), in the posterior tibial artery (11.1%) and in the fibular artery (8.1%). Smoking (P = 0.828), diabetes (P = 0.727) and peripheral arterial occlusive disease (P = 0.172) did not correlate with presence of stenoses. Preoperative lower limb angiography avoids postoperative complications. MRA reliably and non-invasively identifies anatomical variants and arterial stenoses without radiation. Illustration of perforator run-offs enhances incision planning for fibula harvest.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COMPUTED-TOMOGRAPHY ANGIOGRAPHY; DIGITAL-SUBTRACTION-ANGIOGRAPHY; PREOPERATIVE MR-ANGIOGRAPHY; OSTEOCUTANEOUS FLAP; POPLITEAL ARTERY; DIAGNOSTIC PERFORMANCE; LEG ANGIOGRAPHY; HEAD; NECK; RECONSTRUCTION; MR angiography; microvascular reconstruction; free fibula transplantation; lower leg anatomy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 31 Mar 2021 06:53 |
| Last Modified: | 31 Mar 2021 06:53 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45166 |
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