Digital anatomical study of the lateral circumflex femoral artery and its branching patterns
Objective To provide vascular anatomical evidence for the design and harvesting of anterolateral thigh perforator flaps.Methods Thirty-four fresh adult cadavers underwent whole-body vascular angiography,CT scanning,3D reconstruction,and specimen dissection for comprehensive analysis.The branches,course,and distribution areas of the lateral circumflex femoral artery were observed.Anatomical validation was then performed in accordance with the design and harvesting steps of the flap surgery,using 3D reconstructed images.Results A total of 408 anterolateral thigh skin perforators were observed in 65 effective specimens(an average of 6.3 per side),of which 391 originated from the lateral circumflex femoral artery system,accounting for 95.8％(391/408).The distribution among the branches of the lateral circumflex femoral artery was as follows:ascending branch 9.1％(37/408),transverse branch 16.4％(67/408),descending branch 60.8％(248/408),and oblique branch 9.6％(39/408).The external diameters of the perforator origin were(0.7±0.3)mm,(0.9±0.4)mm,(1.1±0.5)mm,and(0.8±0.3)mm,respectively.Seventeen perforators originated from the deep femoral artery,medial circumflex femoral artery,femoral artery,or superficial circumflex iliac artery,accounting for 4.2％,with an external diameter of(0.7±0.3)mm at the origin.Conclusions(l)The descending branch of the lateral circumflex femoral artery remains the primary source vessel for anterolateral thigh perforator flaps.(2)High-level skin perforators mainly originate from the transverse and ascending branches of the lateral circumflex femoral artery.(3)Oblique branches often originate from the common trunk of the ascending and transverse branches,possess a certain external diameter and pedicle length,and can be used as the pedicle for flap harvesting.(4)In cases where the perforators originating from the lateral circumflex femoral artery are thin or absent,flaps can be harvested from high-level skin perforators originating from the medial circumflex femoral artery,femoral artery,or other source vessels.
万方数据
维普
