Application of computer assisted technique to desgin polyfoliate perforator flappedicled on the descending branch of the circumflex femoral lateral artery

Abstract

Objective To explore the feasibility of three-dimensional visualizational reconstruction and virtualization simulated operation of polyfoliate perforator flap pedicled on the descending branch of the circumflex femoral lateral artery. Methods Between October, 2014 and July, 2015, a series of DICOM images were obtained from 12 patients by DSA and dual source CTA. Then the mimics 16.0 was been used to reconstruct the descending branch of the circumflex femoral lateral artery and its perforator vessels. The procedure of free polyfoliate perforator flap pedicled on the descending branch of the circumflex femoral lateral artery had been simulated in personal computer. According to design in the computer, the polyfoliate perforator flaps were designed and dissected for 12 patients who had combined with the huge or irregular wound. Results The 3D reconstruction models could provide perfectly dynamic visualization of the anatomy of the descending branch of the circumflex femoral lateral artery and clearly display three-dimensional relations of blood vessels, skin and adjacent tissue. The procedure of the free polyfoliate perforator flap transfer could be virtually simulated through the mimics soft in the personal computer. Twelve polyfoliate perforator flaps pedicled on the descending branch of the circumflex femoral lateral artery had been transfered with the methods all of flaps were successful survival and donor sites had been directly closed. All patients were followed-up with 1-5 months (mean 3.6 month). The appearance of flaps were satisfactory. Conclusion The 3D reconstruction models can provide a perfect dynamic visualization of the anatomy of the descending branch of the circumflex femoral lateral artery and its perforator vessels which can be used for individualized design of the Polyfoliate perforator flap pedicled on the descending branch of the circumflex femoral lateral artery. Key words: Circumflex femoral lateral artery; Perforator flap; Three-dimensional reconstruction; Angiography; Microsurgical operation