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The lateral calcaneal artery as an alternative recipient vessel option for heel and lateral foot reconstruction
Author(s) -
Woo KyongJe,
Park JinWoo,
Mun GooHyun
Publication year - 2018
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30148
Subject(s) - medicine , heel , peroneal artery , surgery , posterior tibial artery , angiography , fibula , microsurgery , thoracodorsal artery , foot (prosody) , vein , anterior tibial artery , radiology , artery , tibia , free flap , anatomy , linguistics , philosophy
Background Clinical outcomes of consecutive use of the lateral calcaneal artery (LCA) as a recipient vessel for microsurgical reconstruction have not been reported. This study aimed to evaluate the feasibility and safety of the LCA as a recipient vessel for microsurgical foot reconstruction based on anatomical study of CT angiography and clinical results of using this vessel as the recipient. Methods Anatomic study was performed using CT angiography of 61 lower extremities (31 patients). The emerging point, course, and diameter of the LCA were evaluated using 3‐D reconstructed images. The LCA was used as the recipient artery in 17 consecutive patients with a mean age of 59 years (range: 23–77 years). Thoracodorsal artery perforator flap was used in most cases (16 of 17), and clinical outcomes were evaluated. Results The LCA emerged 31.1 ± 9.8 mm proximal and 14.7 ± 5.0 mm posterior to the tip of the fibula and traversed 13.9 ± 2.7 mm posterior to the posterior margin of the lateral malleolus. The accompanying vein was used for venous outflow in five patients and the small saphenous vein was used in the remaining cases. Emergent re‐operation was performed in one case due to venous thrombosis, and salvage was successful. All flaps except for one with partial flap necrosis completely survived. During a mean follow‐up of 13 months, all but one of the patients were able to wear shoes and walk. Conclusions The LCA may be safely used as a recipient vessel for microsurgical heel and lateral foot reconstruction. Level of evidence IV