Abstract
Background The anterolateral thigh flap has gained popularity over the last few decades for
the reconstruction of various surgical defects. The anatomy of the main perforating
vessel of the anterolateral flap, the descending branch of the lateral circumflex
femoral artery (dbLCFA), has been well described in the literature, however only one
study has investigated its patency in patients with significant comorbidities. The
aim of this study is to assess the degree of vascular stenosis of the dbLCFA in patients
with multiple comorbidities.
Patients and Methods A total of 128 sets of angiographic data were collected from 93 patients retrospectively
over a 12-month period. The percentage stenosis of superficial femoral artery (SFA),
LCFA, and dbLCFA was measured and converted into an established scoring system.
Results The rate of dbLCFA stenosis was 12.5%. Interestingly, 24.0% of patients without peripheral
vascular disease (PVD) showed some degree of stenotic changes in the dbLCFA, whereas
only 10.7% of those with PVD had some degree of stenosis. There was no correlation
between dbLCFA stenosis and patient comorbidity. The SFA was significantly affected
by smoking, hypercholesterolemia (p < 0.05), and diabetes mellitus (p < 0.01)
Conclusions This study shows that the dbLCFA is not affected by patient comorbidity including
PVD when compared with medically fit controls. Even in individuals with severe disease
of the superficial vascular system; there is often sparing of the deep system. Surgical
reconstruction using the anterolateral thigh flap is a safe procedure for patients
even with multiple comorbidities including significant PVD and no additional preoperative
investigations are required.
Keywords
anterolateral thigh flap - descending branch of lateral circumflex femoral artery
- vascular stenosis - vascular disease - lower limb angiography
