VIDEO: Preoperative CT Angiography for Fibular Free Flap Reconstructions : American Journal of Roentgenology : Vol. 210, No. 6 (AJR)

June 2018, Volume 210, Number 6

Vascular and Interventional Radiology

Video Article

VIDEO: Preoperative CT Angiography for Fibular Free Flap Reconstructions

Bilal Mujtaba¹, Gaurav K. Synghal¹, Patrick B. Garvey², Behrang Amini¹, Tamara Miner Haygood¹, John E. Madewell¹ and Colleen M. Costelloe¹

+ Affiliations:

¹Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.

²Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.

Citation: American Journal of Roentgenology: W264-W264. 10.2214/AJR.17.19154

ABSTRACT

To view the video(s) associated with this article, please select the following: Supplemental Video.

OBJECTIVE. The objective of this video article is to provide an introduction to the use of fibular free flaps. Normal and variant vascular anatomy of the fibular free flap is discussed, as are imaging acquisition and CT angiography interpretation, computer-assisted design and manufacturing, and the limitations of the fibular free flap.

CONCLUSION. The fibular free flap is commonly used for head and neck reconstructive surgery. Variation exists between individuals regarding the origin of the peroneal artery and the perforating arteries. Our method of performing CT angiography and reporting its findings for patients undergoing a fibular free flap procedure provides a reproducible means of identifying important elements of the vasculature and effectively communicating their locations to surgeons. Accurate communication can maximize the success of the flap harvesting and the preoperative manufacture of custom fibular cutting guides.

Keywords: CT angiography, fi bular free fl ap, mandibular reconstruction, popliteal branching patterns

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Video S1 —Video presents summation of the use of preoperative CT angiography for fi bular free fl ap reconstructions. Download video.

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FOR YOUR INFORMATION

The data supplement accompanying this web exclusive article can be viewed by clicking “Supplemental” at the top of the article.

Address correspondence to C. M. Costelloe ([email protected])