Volume 39 Issue 4
Apr.  2023
Turn off MathJax
Article Contents
Huang YT,Yang L,Cao Y,et al.Morphological study on the transverse branch of lateral femoral circumflex artery based on digital subtraction angiography[J].Chin J Burns Wounds,2023,39(4):337-342.DOI: 10.3760/cma.j.cn501225-20220727-00315.
Citation: Huang YT,Yang L,Cao Y,et al.Morphological study on the transverse branch of lateral femoral circumflex artery based on digital subtraction angiography[J].Chin J Burns Wounds,2023,39(4):337-342.DOI: 10.3760/cma.j.cn501225-20220727-00315.

Morphological study on the transverse branch of lateral femoral circumflex artery based on digital subtraction angiography

doi: 10.3760/cma.j.cn501225-20220727-00315
Funds:

Suzhou Gusu Health Talents Plan Program GSWS2020116

Key Technology Application Research of Suzhou Livelihood Science and Technology Project SS202092

Special Project on Diagnosis and Treatment Technology of Clinical Key Disease Species of Health Science and Education in Suzhou LCZX202026

Special Project of Suzhou Enterprise Engineering Technology Research Center SZS2019263

More Information
  • Corresponding author: Ju Jihui, Email: jjh2006@263.net
  • Received Date: 2022-07-27
  •   Objective   To summarize the morphological characteristics of the transverse branch of lateral femoral circumflex artery (LFCA) using digital subtraction angiography (DSA) and explore its clinical significance.   Methods   A retrospective observational study was conducted. From October 2020 to May 2021, 62 patients with soft tissue injuries in the extremities were hospitalized in Suzhou Ruihua Orthopedic Hospital, including 40 males and 22 females, aged from 20 to 72 years. DSA was performed in the lateral femoral region of patients before the anterolateral thigh flap transplantation, and in combination with imaging scale to observe and measure the general condition of the blood vessels and the occurrence (with the occurrence rate being calculated), source artery, location of the origin point, direction of course, and the location of the perforating point of the cutaneous perforator of the transverse branch of LFCA, and in addition to classify the morphological characteristics of the transverse branch.   Results   DSA detection showed that the femoral artery, the deep femoral artery, and the branches of LFCA were clearly distinguishable in 62 patients. Transverse branches of LFCA were observed in 59 patients, including 52 cases with a single transverse branch, and 7 cases with double transverse branches. The occurrence rate of transverse branches was 95.2% (59/62). A total of 66 transverse branches of LFCA were observed, of which 3 originated from the deep femoral artery, and 63 originated from the LFCA. The origin point of the transverse branch was 6.5-12.7 cm away from the anterior superior iliac spine. The transverse branch which was approximately perpendicular to the long axis of the body, originated outwards, ran between the ascending branch of LFCA and the oblique branch of LFCA, and branched along the way, with the trunk running under the greater trochanter. The perforating point of the cutaneous perforator of the transverse branch was 8.0-18.0 cm away from the anterior superior iliac spine. In the classification of morphological characteristics of the transverse branch of LFCA, the most common type was the one that originated from the same trunk with other branches of LFCA, accounting for 50.0% (31/62), followed by the one that originated from the singular trunk of LFCA (12 cases) or deep femoral artery (3 cases), accounting for 24.2% (15/62); the special type accounted for 21.0% (13/62), including 7 cases of double transverse branches and 6 cases of the transverse branch originated from the same trunk with multiple other branches of LFCA; those with small/absent transverse branch only accounted for 4.8% (3/62). Among the above-mentioned common trunk relationship of two branches, those with shared trunk of ascending and transverse branches were most frequently observed, accounting for 77.4% (24/31); those with shared trunks of the transverse and oblique branches (5 cases) and the transverse and descending branches (2 cases) accounted for 22.6% (7/31) altogether.   Conclusions   A high incidence rate of the transverse branch of LFCA is observed through DSA. The transverse branch originates from the lateral femoral artery approximately perpendicular to the long axis of the body, mainly from the same trunk with another main branch of LFCA, especially the ascending branch. This positioning analysis can provide an important reference for the design and resection of anterolateral femoral flaps.

     

  • loading
  • [1]
    LeeYC,ChenWC,ChouTM,et al.Anatomical variability of the anterolateral thigh flap perforators: vascular anatomy and its clinical implications[J].Plast Reconstr Surg,2015,135(4):1097-1107.DOI: 10.1097/PRS.0000000000001103.
    [2]
    杨林,柳志锦,程俊楠,等.以肌间隔主干型旋股外侧动脉斜支为蒂的股前外侧穿支皮瓣解剖特点与临床应用[J].中华烧伤与创面修复杂志,2022,38(12):1133-1139.DOI: 10.3760/cma.j.cn501225-20220227-00039.
    [3]
    杨力,蔡斌,薛君荣,等.个体化股前外侧皮瓣游离移植修复复杂难愈性创面的临床效果[J].中华烧伤杂志,2020,36(8):730-734.DOI: 10.3760/cma.j.cn501120-20190621-00281.
    [4]
    HartogC,MetzlerC,MeierC,et al.Anatomy of the lateral circumflex femoral artery: does the direct anterior approach to the hip jeopardize vascularization of the proximal femur?[J].Orthop Traumatol Surg Res,2019,105(7):1257-1264.DOI: 10.1016/j.otsr.2019.07.013.
    [5]
    徐达传,阮默,张春,等.股前外侧部皮瓣的进一步解剖学研究——高位皮动脉与皮瓣血供的分型[J].中国临床解剖学杂志,2002,20(6):410-413.DOI: 10.3969/j.issn.1001-165X.2002.06.003.
    [6]
    章伟文,王欣,陈宏,等.旋股外侧动脉横支为蒂的股前外侧皮瓣重建肘部复合组织缺损的临床应用[J].中华手外科杂志,2009,25(4):233-235.DOI: 10.3760/cma.j.issn.1005-054X.2009.04.019.
    [7]
    王培吉,董启榕,秦建忠,等.以旋股外侧动脉高位皮支为蒂的股前外侧皮瓣的临床应用[J].中华显微外科杂志,2007,30(2):88-90,插图2-1.DOI: 10.3760/cma.j.issn.1001-2036.2007.02.003.
    [8]
    程俊楠,柳志锦,杨林,等.基于解剖学研究的三级命名法在旋股外侧动脉主要分支命名中的应用探讨[J].中华解剖与临床杂志,2022,27(1):13-18.DOI: 10.3760/cma.j.cn101202-20210410-00093.
    [9]
    郭建,顾志恺,倪兰春,等.改良Seldinger法经股动脉穿刺置管术的改进[J].中国误诊学杂志,2008,8(24):5839-5840.DOI: 10.3969/j.issn.1009-6647.2008.24.035.
    [10]
    韩婷璐,臧梦青,朱珊,等.以旋股外侧动脉不同分支来源的穿支为蒂的螺旋桨皮瓣手术设计和临床应用[J].中华整形外科杂志,2019,35(9):854-861.DOI: 10.3760/cma.j.issn.1009-4598.2019.09.003.
    [11]
    KimataY,UchiyamaK,EbiharaS,et al.Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases[J].Plast Reconstr Surg,1998,102(5):1517-1523.DOI: 10.1097/00006534-199810000-00026.
    [12]
    KuoYR,Seng-FengJ,KuoFM,et al.Versatility of the free anterolateral thigh flap for reconstruction of soft-tissue defects: review of 140 cases[J].Ann Plast Surg,2002,48(2):161-166.DOI: 10.1097/00000637-200202000-00008.
    [13]
    TsujiN,SugaH,UdaK,et al.Functional evaluation of anterolateral thigh flap donor sites: isokinetic torque comparisons for knee function[J].Microsurgery,2008,28(4):233-237.DOI: 10.1002/micr.20487.
    [14]
    WeiseH,NarosA,BlumenstockG,et al.Donor site morbidity of the anterolateral thigh flap[J].J Craniomaxillofac Surg,2017,45(12):2105-2108.DOI: 10.1016/j.jcms.2017.09.022.
    [15]
    NiuZ,ChenY,LiY,et al.Comparison of donor site morbidity between anterolateral thigh and radial forearm free flaps for head and neck reconstruction: a systematic review and meta-analysis[J].J Craniofac Surg,2021,32(5):1706-1711.DOI: 10.1097/SCS.0000000000007381.
    [16]
    黄钰 以旋股外侧动脉斜支为蒂的游离股前外侧皮瓣修复四肢皮肤缺损 苏州 苏州大学 2020

    黄钰.以旋股外侧动脉斜支为蒂的游离股前外侧皮瓣修复四肢皮肤缺损[D].苏州:苏州大学,2020.

    [17]
    KhoongYM,HuangX,GuS,et al.Imaging for thinned perforator flap harvest: current status and future perspectives[J/OL].Burns Trauma,2021,9:tkab042[2022-07-27].https://pubmed.ncbi.nlm.nih.gov/34926708/.DOI: 10.1093/burnst/tkab042.
    [18]
    胡浩良,陈宏,李苗钟,等.CT血管造影辅助下以旋股外侧动脉斜支血管为蒂的游离股前外侧穿支皮瓣修复四肢软组织缺损[J].中华创伤杂志,2021,37(9):780-785.DOI: 10.3760/cma.j.cn501098-20210126-00072.
    [19]
    张心玉,巨积辉,李雷.应用DSA技术定位股前外侧皮瓣穿支的围手术期护理[J].实用手外科杂志,2020,34(4):494-495.DOI: 10.3969/j.issn.1671-2722.2020.04.041.
    [20]
    余炯 MRA在股前外侧皮瓣中穿支血管定位的应用 苏州 苏州大学 2017

    余炯.MRA在股前外侧皮瓣中穿支血管定位的应用[D].苏州:苏州大学,2017.

    [21]
    陆泳宇.3D-CTA与3D-DSA对于老年颅内动脉瘤的应用价值对比[J].影像研究与医学应用,2021,5(11):197-198.DOI: 10.3969/j.issn.2096-3807.2021.11.097.
    [22]
    何晓清,杨曦,段家章,等.基于CTA精准皮瓣外科的理念与初步实践[J].中华骨科杂志,2022,42(6):365-373.DOI: 10.3760/cma.j.cn121113-20211119-00669.
    [23]
    NewmanTM,VasileJ,LevineJL,et al.Perforator flap magnetic resonance angiography for reconstructive breast surgery: a review of 25 deep inferior epigastric and gluteal perforator artery flap patients[J].J Magn Reson Imaging,2010,31(5):1176-1184.DOI: 10.1002/jmri.22136.
    [24]
    刘亮 彩超应用于旋股外侧动脉降支穿支皮瓣穿支定位的临床研究 衡阳 南华大学 2017

    刘亮.彩超应用于旋股外侧动脉降支穿支皮瓣穿支定位的临床研究[D].衡阳:南华大学,2017.

    [25]
    段家章 数字化技术在股前外侧皮瓣血管解剖学及修复创面中的应用研究 重庆 第三军医大学 2016

    段家章.数字化技术在股前外侧皮瓣血管解剖学及修复创面中的应用研究[D].重庆:第三军医大学,2016.

    [26]
    赵振华,杨建峰,王伯胤,等.MRA、CTA与DSA在股前外侧皮瓣移植术前应用的对比研究[J].中华整形外科杂志,2015,31(3):172-175.DOI: 10.3760/cma.j.issn.1009-4598.2015.03.004.
    [27]
    TotlisT,PaparoidamisG,TerzidisI,et al.Surgical anatomy of the lateral circumflex femoral artery branches: contribution to the blood loss control during hip arthroplasty[J].Ann Anat,2020,232:151566.DOI: 10.1016/j.aanat.2020.151566.
    [28]
    高增阳,刘超,佘立军,等.以旋股外侧动脉降支外侧支为血管蒂的ALTPF切取及临床应用[J].中华显微外科杂志,2021,44(5):512-516.DOI: 10.3760/cma.j.cn441206-20210619-00159.
    [29]
    李雷,巨积辉,周正虎,等.DSA技术结合多普勒彩超在股前外侧皮瓣穿支定位中的应用[J].中国临床解剖学杂志,2020,38(3):331-334.DOI: 10.13418/j.issn.1001-165x.2020.03.017.
    [30]
    王强,巨积辉,王臻,等.数字减影血管造影技术在股前外侧皮瓣修复上肢创面时判断受区血管损伤中的应用[J].中国美容整形外科杂志,2022,33(3):143-146.DOI: 10.3969/j.issn.1673-7040.2022.03.005.
    [31]
    ZhaoN,ChenZ,ZhouY,et al.Effects of a high dose of the contrast medium iodixanol on renal function in patients following percutaneous coronary intervention[J].Angiology,2021,72(2):145-152.DOI: 10.1177/0003319720953044.
    [32]
    金依依,朱素燕,徐萍.碘克沙醇致冠状动脉介入治疗术后造影剂脑病1例[J].中国临床药学杂志,2021,30(4):302-304.DOI: 10.19577/j.1007-4406.2021.04.015.
    [33]
    单荟芳,刘静,徐珽.碘克沙醇致迟发型皮肤过敏反应1例[J].中国临床药学杂志,2022,31(2):147-149.DOI: 10.19577/j.1007-4406.2022.02.015.
    [34]
    ManninenAL,IsokangasJM,KarttunenA,et al.A comparison of radiation exposure between diagnostic CTA and DSA examinations of cerebral and cervicocerebral vessels[J].AJNR Am J Neuroradiol,2012,33(11):2038-2042.DOI: 10.3174/ajnr.A3123.
    [35]
    GabrielM,PawlaczykK,WaliszewskiK,et al.Location of femoral artery puncture site and the risk of postcatheterization pseudoaneurysm formation[J].Int J Cardiol,2007,120(2):167-171.DOI: 10.1016/j.ijcard.2006.09.018.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(4)

    Article Metrics

    Article views (216) PDF downloads(21) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return