Developments in image-guided deep circumflex iliac artery flap harvest: a step-by-step guide and literature review

Jeannette Wen Ching Ting, Warren Rozen, Vachara Niumsawatt, Charles Baillieu, Michael Leung, James Chin Sek Leong

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)

Abstract

Purpose The deep circumflex iliac artery (DCIA) flap has evolved significantly over time in the intricacies of flap design and breadth of surgical application. This has been facilitated by advances in preoperative imaging and planning, in particular, computed tomographic angiography. Studies have highlighted that advanced imaging modalities and other technologies such as image-guided stereolithographic biomodeling can substantially improve flap planning, flap harvest, and operative outcomes. Patients and Methods The present report comprises a combined literature review and clinical cohort study of 20 consecutive patients to assess the modern technologies applied to DCIA flap planning and harvest. We have also described a step-by-step guide for the implementation of these techniques into clinical practice. Results The protocol for a single, standardized technique of computed tomographic angiography scanning is presented and was applied to a range of techniques in the preoperative planning of DCIA flaps. These include 1) bony and vascular imaging analysis of both donor and recipient sites, 2) stereolithographic biomodeling of both donor and recipient bony and vascular anatomy, and 3) the use of preoperative virtual surgery with image-guided stereotactic navigation. The application and role of each technique was explored. Conclusions Modern imaging and stereolithographic techniques are innovations that can substantially improve surgical outcomes in DCIA flap surgery, such as has been highlighted in our clinical experience and in published studies. Notably, few outcome studies have been reported, and the need for larger case series and comparative studies is apparent.
Original languageEnglish
Pages (from-to)186 - 197
Number of pages12
JournalJournal of Oral and Maxillofacial Surgery
Volume72
Issue number1
DOIs
Publication statusPublished - 2014

Cite this

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title = "Developments in image-guided deep circumflex iliac artery flap harvest: a step-by-step guide and literature review",
abstract = "Purpose The deep circumflex iliac artery (DCIA) flap has evolved significantly over time in the intricacies of flap design and breadth of surgical application. This has been facilitated by advances in preoperative imaging and planning, in particular, computed tomographic angiography. Studies have highlighted that advanced imaging modalities and other technologies such as image-guided stereolithographic biomodeling can substantially improve flap planning, flap harvest, and operative outcomes. Patients and Methods The present report comprises a combined literature review and clinical cohort study of 20 consecutive patients to assess the modern technologies applied to DCIA flap planning and harvest. We have also described a step-by-step guide for the implementation of these techniques into clinical practice. Results The protocol for a single, standardized technique of computed tomographic angiography scanning is presented and was applied to a range of techniques in the preoperative planning of DCIA flaps. These include 1) bony and vascular imaging analysis of both donor and recipient sites, 2) stereolithographic biomodeling of both donor and recipient bony and vascular anatomy, and 3) the use of preoperative virtual surgery with image-guided stereotactic navigation. The application and role of each technique was explored. Conclusions Modern imaging and stereolithographic techniques are innovations that can substantially improve surgical outcomes in DCIA flap surgery, such as has been highlighted in our clinical experience and in published studies. Notably, few outcome studies have been reported, and the need for larger case series and comparative studies is apparent.",
author = "Ting, {Jeannette Wen Ching} and Warren Rozen and Vachara Niumsawatt and Charles Baillieu and Michael Leung and Leong, {James Chin Sek}",
year = "2014",
doi = "10.1016/j.joms.2013.06.219",
language = "English",
volume = "72",
pages = "186 -- 197",
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Developments in image-guided deep circumflex iliac artery flap harvest: a step-by-step guide and literature review. / Ting, Jeannette Wen Ching; Rozen, Warren; Niumsawatt, Vachara; Baillieu, Charles; Leung, Michael; Leong, James Chin Sek.

In: Journal of Oral and Maxillofacial Surgery, Vol. 72, No. 1, 2014, p. 186 - 197.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Developments in image-guided deep circumflex iliac artery flap harvest: a step-by-step guide and literature review

AU - Ting, Jeannette Wen Ching

AU - Rozen, Warren

AU - Niumsawatt, Vachara

AU - Baillieu, Charles

AU - Leung, Michael

AU - Leong, James Chin Sek

PY - 2014

Y1 - 2014

N2 - Purpose The deep circumflex iliac artery (DCIA) flap has evolved significantly over time in the intricacies of flap design and breadth of surgical application. This has been facilitated by advances in preoperative imaging and planning, in particular, computed tomographic angiography. Studies have highlighted that advanced imaging modalities and other technologies such as image-guided stereolithographic biomodeling can substantially improve flap planning, flap harvest, and operative outcomes. Patients and Methods The present report comprises a combined literature review and clinical cohort study of 20 consecutive patients to assess the modern technologies applied to DCIA flap planning and harvest. We have also described a step-by-step guide for the implementation of these techniques into clinical practice. Results The protocol for a single, standardized technique of computed tomographic angiography scanning is presented and was applied to a range of techniques in the preoperative planning of DCIA flaps. These include 1) bony and vascular imaging analysis of both donor and recipient sites, 2) stereolithographic biomodeling of both donor and recipient bony and vascular anatomy, and 3) the use of preoperative virtual surgery with image-guided stereotactic navigation. The application and role of each technique was explored. Conclusions Modern imaging and stereolithographic techniques are innovations that can substantially improve surgical outcomes in DCIA flap surgery, such as has been highlighted in our clinical experience and in published studies. Notably, few outcome studies have been reported, and the need for larger case series and comparative studies is apparent.

AB - Purpose The deep circumflex iliac artery (DCIA) flap has evolved significantly over time in the intricacies of flap design and breadth of surgical application. This has been facilitated by advances in preoperative imaging and planning, in particular, computed tomographic angiography. Studies have highlighted that advanced imaging modalities and other technologies such as image-guided stereolithographic biomodeling can substantially improve flap planning, flap harvest, and operative outcomes. Patients and Methods The present report comprises a combined literature review and clinical cohort study of 20 consecutive patients to assess the modern technologies applied to DCIA flap planning and harvest. We have also described a step-by-step guide for the implementation of these techniques into clinical practice. Results The protocol for a single, standardized technique of computed tomographic angiography scanning is presented and was applied to a range of techniques in the preoperative planning of DCIA flaps. These include 1) bony and vascular imaging analysis of both donor and recipient sites, 2) stereolithographic biomodeling of both donor and recipient bony and vascular anatomy, and 3) the use of preoperative virtual surgery with image-guided stereotactic navigation. The application and role of each technique was explored. Conclusions Modern imaging and stereolithographic techniques are innovations that can substantially improve surgical outcomes in DCIA flap surgery, such as has been highlighted in our clinical experience and in published studies. Notably, few outcome studies have been reported, and the need for larger case series and comparative studies is apparent.

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