Anatomical CT study of lumbar artery perforator flap in women

Background: The lumbar artery perforator (LAP) flap is an important autologous option in breast reconstruction. As the lumbar perforator flap is relatively new in this field, several questions remain regarding preoperative preparation, especially concerning computed tomography (CT) and magnetic reso...

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Main Authors: Olesya Startseva, Igor Reshetov, Jaume Masia, Alexandra Frolova, Elena Mershina, Evgeniya Zhigailova, Mark Gabriyanchik
Format: Article
Language:English
Published: KeAi Communications Co. Ltd. 2025-06-01
Series:Chinese Journal of Plastic and Reconstructive Surgery
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Online Access:http://www.sciencedirect.com/science/article/pii/S2096691125000032
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author Olesya Startseva
Igor Reshetov
Jaume Masia
Alexandra Frolova
Elena Mershina
Evgeniya Zhigailova
Mark Gabriyanchik
author_facet Olesya Startseva
Igor Reshetov
Jaume Masia
Alexandra Frolova
Elena Mershina
Evgeniya Zhigailova
Mark Gabriyanchik
author_sort Olesya Startseva
collection DOAJ
description Background: The lumbar artery perforator (LAP) flap is an important autologous option in breast reconstruction. As the lumbar perforator flap is relatively new in this field, several questions remain regarding preoperative preparation, especially concerning computed tomography (CT) and magnetic resonance imaging of the donor site. The objective of this study was to aid the surgical approach to the LAP flap in female patients by precisely determining the characteristics of the lumbar perforators. Methods: We retrospectively reviewed the computed tomographic angiography images of 20 patients who underwent evaluation of the perforator positions from the four lumbar arteries. Four characteristics were studied: length, diameter, path of the lumbar pedicle, and thickness of the tissues available for transfer. Results: We analyzed 20 CT images, identifying 149 perforating vessels of the lumbar artery. The most suitable perforator for flap harvesting was the L4 perforator, which exhibited a larger diameter, a greater number of perforasomes, and a higher percentage of the cutaneous-septal tract. Conclusion: The LAP flap is a viable option for breast reconstruction and as a free flap in women. The L4 perforator artery is the most suitable for harvesting, owing to its superior perfusion capacity, diameter, and course; however, an interposition graft may be required to lengthen the vascular pedicle.
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spelling doaj-art-dfea94a65bf0445bb86aa92a3fa4e17f2025-08-20T02:22:01ZengKeAi Communications Co. Ltd.Chinese Journal of Plastic and Reconstructive Surgery2096-69112025-06-0172788210.1016/j.cjprs.2025.02.001Anatomical CT study of lumbar artery perforator flap in womenOlesya Startseva0Igor Reshetov1Jaume Masia2Alexandra Frolova3Elena Mershina4Evgeniya Zhigailova5Mark Gabriyanchik6Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian FederationFederal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian FederationDepartment of Plastic Surgery, Hospital of the Holy Cross and Saint Paul, Barcelona, 08025, Spain; Unit of Advanced Breast Reconstruction and Lymphedema Treatment, Clinica Planas, Barcelona, 08034, SpainFederal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian FederationDepartment of Radiology, Lomonosov Moscow State University Hospital, Moscow, 119234, Russian FederationFederal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian FederationFederal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation; Corresponding author. Department of Oncology, Radiotherapy, and Plastic Surgery, Institute of Clinical Medicine, First Moscow State Medical University (Sechenov University), Trubetskaya St., 8, Moscow, 119991, Russian Federation.Background: The lumbar artery perforator (LAP) flap is an important autologous option in breast reconstruction. As the lumbar perforator flap is relatively new in this field, several questions remain regarding preoperative preparation, especially concerning computed tomography (CT) and magnetic resonance imaging of the donor site. The objective of this study was to aid the surgical approach to the LAP flap in female patients by precisely determining the characteristics of the lumbar perforators. Methods: We retrospectively reviewed the computed tomographic angiography images of 20 patients who underwent evaluation of the perforator positions from the four lumbar arteries. Four characteristics were studied: length, diameter, path of the lumbar pedicle, and thickness of the tissues available for transfer. Results: We analyzed 20 CT images, identifying 149 perforating vessels of the lumbar artery. The most suitable perforator for flap harvesting was the L4 perforator, which exhibited a larger diameter, a greater number of perforasomes, and a higher percentage of the cutaneous-septal tract. Conclusion: The LAP flap is a viable option for breast reconstruction and as a free flap in women. The L4 perforator artery is the most suitable for harvesting, owing to its superior perfusion capacity, diameter, and course; however, an interposition graft may be required to lengthen the vascular pedicle.http://www.sciencedirect.com/science/article/pii/S2096691125000032LAP-FlapBreast reconstructionCT-StudyPerforator flap
spellingShingle Olesya Startseva
Igor Reshetov
Jaume Masia
Alexandra Frolova
Elena Mershina
Evgeniya Zhigailova
Mark Gabriyanchik
Anatomical CT study of lumbar artery perforator flap in women
Chinese Journal of Plastic and Reconstructive Surgery
LAP-Flap
Breast reconstruction
CT-Study
Perforator flap
title Anatomical CT study of lumbar artery perforator flap in women
title_full Anatomical CT study of lumbar artery perforator flap in women
title_fullStr Anatomical CT study of lumbar artery perforator flap in women
title_full_unstemmed Anatomical CT study of lumbar artery perforator flap in women
title_short Anatomical CT study of lumbar artery perforator flap in women
title_sort anatomical ct study of lumbar artery perforator flap in women
topic LAP-Flap
Breast reconstruction
CT-Study
Perforator flap
url http://www.sciencedirect.com/science/article/pii/S2096691125000032
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