Introduction:

The anterolateral thigh flap has gained popularity for use in free tissue transfer especially in head and neck reconstruction. However, its dissection can be technically demanding and has some variability in its vascular anatomy. CT angiography of the lower extremity could be a useful tool in preoperative assessment of these patients to map out the pedicle and identify perforators sufficient for successful free tissue transfer. Our objectives were to see if CT angiography is capable of identifying the lateral femoral circumflex artery with its subsequent tributaries and attempt to radiographically “map” these vessels for clinical application.

Methods:

Ten patients undergoing CT angiography of the lower extremity were selected for this study. Results were reviewed by both radiologist and plastic surgeon to examine the location and course of the vascular system from the lateral femoral circumflex artery. These results were then examined with volume rendering to delineate the vascular system 3-Dimensionally. Next, surface mapping of this system was attempted onto the skin surface.

Results:

CT angiography is capable to identify the lateral femoral circumflex artery and its subsequent tributaries.

Discussion: CT angiography can be a useful tool for the microsurgeon preparing to use the anterolateral thigh flap and carries less morbidity and cost than an arteriogram. However, with financial resources declining in health care, the popularity of its use may be limited.