Delineating the Vascular Territory (Perforasome) of a Perforator in the Lower Extremity of the Rabbit with Four-Dimensional Computed Tomographic Angiography

Background: The anatomy of any particular vascular perforator relative to its vascular territory (perforasome) and flow characteristics is unique and complex. This arterial perforasome study with laboratory rabbits was conducted to assess four-dimensional computed tomographic angiography as an imaging tool for the design of individualized tissue transfers. This study offers clinically relevant information that should improve flap survival. Methods: Six New Zealand White rabbits weighing 3.0 to 3.25 kg underwent contrast-enhanced four-dimensional computed tomographic angiography in a 128-slice scanner after intraarterial injection of iopromide iodinated contrast material. Based on the image data, the perforasome of the posterior thigh perforator was marked onto the posterior thigh skin. The perforasome size was confirmed by microangiography. Data from four-dimensional computed tomographic angiography and microangiography were statistically compared. Results: Four-dimensional computed tomographic angiography clearly and accurately delineated the perfusion and vascular territories of the perforators. The area of the perforator flap as measured with four-dimensional computed tomographic angiography compared favorably to that obtained by means of microangiography; there was no statistically significant difference in the results from the two methods. Conclusions: This study demonstrated that four-dimensionalcomputedtomographic angiography was capable of accurately characterizing the vascular territory and flow characteristics of the arterial perforator in live rabbits. This technique for determining perforator location, axiality, and optimal perfusion territory will potentially benefit human patients. (Plast. Reconstr. Surg. 131: 565, 2013.)