Dual-phase CT angiography for presurgical planning in patients with vessel-depleted neck.

Abstract

Microvascular reconstruction in vessel-depleted necks is challenging due to limited availability of recipient vessels. We examine the utility of dual-phase CT angiography (CTA), which delineates both arteries and veins, for preoperative planning in such difficult cases. Retrospective chart review of a single surgeon from July 2013 to July 2017 in a tertiary referral center was performed. Patient characteristics, operative details, and surgical outcomes were examined. Thirteen patients met inclusion criteria. The operative plan was changed to a local flap for one patient as a result of imaging; free tissue transfer was performed for the remaining cases with 100% flap survival rate. Average operative time and ischemia time were 524 ± 110 minutes and 153 ± 47 minutes, respectively. Dual-phase CTA can evaluate potential venous and arterial recipient vessel and guide surgical explorations. As such, it may aid in presurgical planning for microvascular free tissue transfer in vessel-depleted necks.