The Imaging Study And Clinical Application Of Crus Artery Wear Vascular

Objective:Through the lower limbs of patients artery Angiography images were studied retrospectively, analysis the vascular anastomosis of peroneal artery perforator vessels, anterior tibial artery perforator vessels and posterior tibial artery perforator vessels,providing the designing and clinical application Radiographic evidence for crus perforator flap.Methods:Collecte the Imaging results of59patients which accept the check of Lower limb artery angiography in our hospital in September2010-May2012to make a retrospective study. Observe the walk direction, distribution range and the connection of posterior tibial artery perforator vessels, anterior tibial artery perforator vessels and peroaeal artery perforator vessels. Peroneal artery perforator flap, before tibial arterial perforator flap and posterior tibial arterial perforator flap were respectively used to repair the calf and foot skin, soft tissue defect and give patients postoperative follow-up.Results:Through the retrospective study of Angiography images, we found that in the process of peroneal artery perforator vessels, anterior tibial artery perforator vessels and posterior tibial artery perforator vessels running toward skin,adjacent perforator vessels issued branches, forming "interlocking" direct linking vessel,lead to the skin tissue blood flow "channels" have a distinct direction(Fig.1,2,3).The proportion of posterior tibial artery perforator flap and peroneal artery perforator flap are all greater than pumping blood range of two perforasomes, Without blood supply obstacles(Fig.4,5,6,7); the proportion of anterior tibial artery perforator flap greater than pumping blood range of two perforasomes, but The far end has part of skin flap necrosis(Fig.8,9). Conclusion:1. Through artery angiography, the form and running direction of perforator vessels and the connection mode of adjacent perforator vessels can be clearly revealed.2. Running direction of linking vessels that come from adjacent septocutaneous perforator vessels is same as axial vessel, so flap axis should be the same as axial vessel surface projection.3. There are direct linking vessels in posterior tibial artery perforator flap、 anterior tibial artery perforator flap and peroneal artery perforator flap,and throughout the flap.The collateral circulation in posterior tibial artery perforator flap and peroneal artery perforator flap was strengthened by reticulate vessel system.So the proportion of these flaps could be cut off greater than the distribution range of two perforasomes, without blood supply obstacles.4. The method of digital subtraction angiography has more advantage than traditional artery perfusion-anatomy.