Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Sci Rep. 2021 Oct 1;11(1):19584. doi: 10.1038/s41598-021-99203-1.
Fibular free flap (FFF) is frequently used for reconstruction requiring vascularized bone. Thus, understanding its vasculature variation is crucial. This study investigates the popliteal artery branching variations in Thai cadavers and compares them with previous studies. One hundred and sixty-two legs from 81 formalin-embalmed cadavers were dissected. The popliteal artery branching patterns were classified. The previous data retrieved from cadaveric and angiographic studies were also collected and compared with the current study. The most common pattern is type I-A (90.7%). For the variants, type III-A was the majority among variants (6.2%). Type IV-A, hypoplastic peroneal artery, was found in one limb. A symmetrical branching pattern was found in 74 cadavers. Compared with cadaveric studies, type III-B and III-C are significantly common in angiographic studies (p = 0.015 and p = 0.009, respectively). Type I-A is most common according to previous studies. Apart from this, the prevalence of type III-A variant was higher than in previous studies. Furthermore, type III-B and III-C are more frequent in angiographic studies which might be from atherosclerosis. Thus, if the pre-operative CTA policy is not mandatory, the patients at risk for atherosclerosis and population with high variants prevalence should undergo pre-operative CTA with cost-effectiveness consideration.
腓骨游离皮瓣（FFF）常用于需要血管化骨骼的重建。因此，了解其血管变异至关重要。本研究调查了泰国尸体的腘动脉分支变异，并与之前的研究进行了比较。从 81 具福尔马林固定的尸体中解剖了 162 条腿。对腘动脉分支模式进行了分类。还收集了以前从尸体和血管造影研究中检索到的数据，并与本研究进行了比较。最常见的模式是 I-A 型（90.7%）。对于变体，III-A 型是变体中最常见的（6.2%）。在一条肢体中发现了 IV-A 型发育不良的腓动脉。74 具尸体中发现了对称分支模式。与尸体研究相比，III-B 和 III-C 型在血管造影研究中更为常见（p=0.015 和 p=0.009）。根据以往的研究，I-A 型最为常见。除此之外，III-A 型变体的发生率高于以往的研究。此外，III-B 和 III-C 型在血管造影研究中更为常见，这可能是由于动脉粥样硬化所致。因此，如果术前 CTA 政策不是强制性的，那么有动脉粥样硬化风险的患者和高变体发生率的人群应在考虑成本效益的情况下进行术前 CTA。
