Using 320-slice computed tomography to preoperatively investigate the leg perforator arterial system and design a perforator flap for patients with a soft-tissue defect in the leg

To investigate the leg perforator arterial system, identify the perforator flap's pedicle artery and its projected cutaneous point using a 320-slice computed tomography (CT 320) scanner. A total of 24 patients with leg soft-tissue defects unilaterally underwent 320-slice CT angiography scanning (CTA 320) with 47 legs. The used method enabled investigation of the perforator arteries originating from the tibial, peroneal arteries, perforator flap's pedicle artery and its projected cutaneous point. These data were used to preoperatively design an improved flap. Then, the CT-confirmed location and length of the flap's pedicle artery were compared with intraoperative findings. Findings of the CTA 320 on 47 legs showed that 217 perforator arteries with diameters of ≥0.5mm were detected; the average number of arteries per leg, their average length and diameter were 4.6±2.1, 30.7±10.4mm and 1.16±0.27mm, respectively. The perforator arteries originating from the anterior tibial artery were mainly distributed in the proximal and middle thirds of the leg. Perforators from the posterior tibial and peroneal arteries were distributed abundantly in the middle and distal thirds of the leg. As identified in the CT, the location and length of the flap's pedicle artery and its projected cutaneous point were consistent with those observed during the surgery. The CTA 320 is a minimally invasive imaging method that provides high-quality images of the leg perforator arterial system and can identify the exact location and projected cutaneous point of the perforator flap's pedicle artery. Investiguer le système artériel perforateur de la jambe, identifier l’artère pédiculée du lambeau perforateur et son point cutané projeté en utilisant un scanner à tomodensitométrie à 320 coupes (CT 320). Un total de 24 patients présentant des défauts des tissus mous à la jambe ont subi une angiographie par tomodensitométrie à 320 coupes (CTA 320) unilatérale avec 47 jambes. La méthode utilisée a permis d’investiguer les artères perforatrices issues des artères tibiale et péronière, l’artère pédonculée du lambeau perforateur et son point cutané projeté. Ces données ont été utilisées pour concevoir préopératoirement un lambeau amélioré. Ensuite, l’emplacement et la longueur de l’artère pédiculée du lambeau confirmés par la CT ont été comparés aux résultats intraopératoires. Les résultats de la CTA 320 sur 47 jambes ont montré que 217 artères perforatrices d’un diamètre ≥0,5mm ont été détectées ; l