组织工程与重建外科杂志2025，Vol.21Issue(2)：119-124,6.DOI:10.3969/j.issn.1673-0364.2025.02.002
腓肠内、外侧动脉的DSA观察及其在皮瓣移植中的应用
DSA observations of the medial and lateral gastrocnemius arteries and their use in flap grafting
摘要
Abstract
Objective To observe the course and branches of the medial and lateral sural arteries using digital subtraction angiography(DSA)and to guide the application of perforator flaps from these arteries in repairing wounds in the middle and upper segments of the lower leg.Methods A total of 10 patients with deep defects in the middle and upper segment of lower leg who received medial or lateral sural artery perforator flap transplantation were included in this study from September 2021 to September 2023.Preoperative DSA was performed to assess the course and branching patterns of the medial and lateral sural arteries.Additionally,handheld Doppler ultrasonography was utilized to precisely locate the perforators.The flaps were designed based on the location and size of the wound.The donor sites were either directly sutured or repaired by skin grafting.Postoperative follow-up was conducted to evaluate the recovery of limb function.Results DSA revealed that the medial and lateral sural arteries descended from the popliteal artery,entering the medial and lateral heads of the gastrocnemius muscle,respectively.Based on the number of descending branches,the arteries were classified into four types:Type I(one main vessel trunk with no branches,7 cases),type IIA(the main vessel formed 2 branches above the knee joint,3 cases),type IIB(the main vessel formed 2 branches below the knee joint,4 cases),and type Ⅲ(the main vessel formed≥3 branches,6 cases).The diameters of the medial and lateral sural arteries at their origin were(1.59±0.6)mm and(1.47±0.58)mm,respectively.Handheld Doppler ultrasonography detected 1 to 4 perforators,with a mean of 2.All medial and lateral sural artery perforator flaps survived successfully.Follow-up showed that the color,texture,and appearance of the flap was satisfactory and that the function of the affected limbs were restored.Conclusion DSA can provide clear visualization of the course and branching patterns of the medial and lateral sural arteries.Combined with handheld Doppler ultrasonography detection for perforators,it can effectively guide the preoperative design and intraoperative dissection of perforator flaps supplied by these arteries.Medical and lateral sural perforator flaps can achieve favorable outcomes in wound repair of the middle and upper segments of the lower leg.关键词
数字减影血管造影/腓肠内侧和外侧动脉/穿支皮瓣/创面修复Key words
Digital subtraction angiography/Medial and lateral peroneal arteries/Perforator flap/Wound repair分类
临床医学引用本文复制引用
张海钰,仲海燕,陈勇,王倩,袁斯明..腓肠内、外侧动脉的DSA观察及其在皮瓣移植中的应用[J].组织工程与重建外科杂志,2025,21(2):119-124,6.基金项目
江苏省自然科学基金面上项目(BK20231504) （BK20231504）
东部战区总医院课题(22LCZLXJS4,22JCYYYB37). （22LCZLXJS4,22JCYYYB37）
