Three-dimensional venous visualization with phase-lag computed tomography angiography for reconstructive microsurgery

Journal of Reconstructive Microsurgery
Shunsuke SakakibaraHiroto Terashi

Abstract

Most free flap reconstruction complications involve vascular compromise. Evaluation of vascular anatomy provides considerable information that can potentially minimize these complications. Previous reports have shown that contrast-enhanced computed tomography is effective for understanding three-dimensional arterial anatomy. However, most vascular complications result from venous thromboses, making imaging of venous anatomy highly desirable. The phase-lag computed tomography angiography (pl-CTA) technique involves 64-channel (virtually, 128-channel) multidetector CT and is used to acquire arterial images using conventional CTA. Venous images are three-dimensionally reconstructed using a subtraction technique involving combined venous phase and arterial phase images, using a computer workstation. This technique was used to examine 48 patients (12 lower leg reconstructions, 34 head and neck reconstructions, and 2 upper extremity reconstructions) without complications. The pl-CTA technique can be used for three-dimensional visualization of peripheral veins measuring approximately 1 mm in diameter. The pl-CTA information was especially helpful for secondary free flap reconstructions in the head and neck region after malignant tumor...Continue Reading

Citations

Sep 4, 2015·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·J WeitzM R Kesting
Dec 12, 2018·Plastic and Reconstructive Surgery·David E JanhoferKaren Kim Evans
Dec 29, 2019·Plastic and Reconstructive Surgery·David E JanhoferKaren Kim Evans

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