Determination of Lower Limb Microvasculature by In

Authors: Jingying Nie Laijin Lu Xu Gong Junjie Nie Qi Li Ming Sun

Publish Date: 2012/09/05

Volume: 36, Issue: 6, Pages: 1376-1381

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Abstract

Computed tomographyassisted angiography CTA for lower limb vasculature can identify perforators only as small as 1 mm in diameter The technique does not clearly show the microvascularity in subdermal layers of the skin This study investigated a novel method of CTA using intrafemoral injection of contrast medium instead of intravenous injection to display the vascular anatomy of small perforators with a diameter less than 1 mm in the lower extremities of rabbitsPosterior thigh perforator surgery was performed for 15 New Zealand rabbits weighing 25 to 35 kg Five rabbits underwent anatomic dissection to determine the vascular anatomy of the posterior thigh perforator and its location relative to adjacent structures Of the remaining 10 rabbits 5 were subjected to CTA scanning after injection of iodine contrast through a microcatheter inserted into the femoral artery and 5 were subjected to CTA scanning through venous injection of contrast media The latter group was designated as the control group 10 extremities Images were viewed using a dedicated workstation Postoperative outcomes and complications were monitored for 7 days after the procedureAll the CTA images of intraartery administration clearly showed that the posterior thigh perforators originated from the popliteal artery Injection of contrast agent through the femoral artery improved resolution of the CTA enabling visualization of perforator arteries with diameters in the range of 03 to 04 mm The images of the control group indicated the course of the perforator in the muscle of only six legs The images of the remaining four legs did not display the perforator The CTAtreated animals recovered without any complications The anatomic dissection matched the CTA mappingComputed tomographyassisted angiography using intraarterial injection of contrast media enables visualization of vessels smaller than 1 mm in diameter The described animal model also showed the presence of vascular branches in the subdermis This imaging technique may help in the preoperative design of perforator flaps for use in clinical practice

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