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The Use of Computed Tomographic Angiography and Colour Doppler Ultrasound in the Planning of Anterolateral Thigh Flap
EP34384
Poster Title: The Use of Computed Tomographic Angiography and Colour Doppler Ultrasound in the Planning of Anterolateral Thigh Flap
Submitted on 30 Oct 2020
Author(s): Marcus Cheng, Jason Wong, Niki Koutrouza, Derek Neoh, Sally Ng
Affiliations: Austin Health, Melbourne, Australia
This poster was presented at BIR Annual Congress 2020
Poster Views: 227
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Poster Information
Abstract: Objective
Perforator flap, in particular the anterolateral thigh (ALT) flap, is the workhorse for oncological and traumatic reconstruction in plastic surgery. The use of pre-operative imaging plays a crucial role in the planning and designing of the ALT flap. Whilst Computer Tomographic Angiography (CTA) remains as the gold standard, Colour Doppler Ultrasonography (CDU) is gaining favour due to its ease of use and accuracy in identifying the perforators. Our study aims to describe the vascular anatomy and anatomical variance in the anterolateral thigh, as well as presenting the technique and protocol used in CTA and CDU for the purpose of planning the ALT flap.

Methods and Results
The protocol and technique used in CTA and CDU to assess the perforator anatomy is presented, with a number of clinical examples highlighting the importance of pre-operative imaging in the identification of suitable perforators.

Conclusion
Pre-operative imaging in perforator flaps is becoming more popular as it improves surgical efficiency and patient safety. It is important to protocol and perform the imaging appropriately in order to optimally visualise the perforators. An understanding of the vascular anatomy in the anterolateral thigh will assist in the localisation of suitable perforators and therefore assist with the surgical planning.
Summary: The Use of Computed Tomographic Angiography and Colour Doppler Ultrasound in the Planning of Anterolateral Thigh flapReferences: Beule, TD, Deun, WV, Vranckx, J, Dobbelaere, B de, Maleux, G & Heye, S 2016, “Anatomical variations and pre-operative imaging technique concerning the anterolateral thigh flap: guiding the surgeon,” The British Journal of Radiology, vol. 89, no. 1063, p. 20150920.

Seth, R, Manz, RM, Dahan, IJ, Nuara, MJ, Meltzer, NE, McLennan, G & Alam, DS 2011, “Comprehensive Analysis of the Anterolateral Thigh Flap Vascular Anatomy,” Archives of Facial Plastic Surgery, vol. 13, no. 5, pp. 347–354.

Xiao, W, Li, K, NG, SK-H, Feng, S, Zhou, H, Nicoli, F, Blondeel, P & Zhang, Y 2020, “A Prospective Comparative Study of Color Doppler Ultrasound and Infrared Thermography in the Detection of Perforators for Anterolateral Thigh Flaps,” Annals of Plastic Surgery, vol. 84, no. 5S, pp. S190–S195.

Song, Ye-guang, Chen, G & Song, Ye-liang 1984, “The free thigh flap: a new free flap concept based on the septocutaneous artery,” British Journal of Plastic Surgery, vol. 37, no. 2, pp. 149–1
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