Anterior Interosseous Artery as a Recipient Vessel in Superficial Circumflex Iliac Artery Perforator Flap Transplantation to the Forearm

Background

When transplanting a superficial circumflex iliac artery perforator (SCIP) flap to the forearm, the small diameter of the superficial circumflex iliac artery (SCIA) complicates end-to-end anastomosis with the radial or ulnar artery. The small diameter of the anterior interosseous artery (AIA) may make it suitable for end-to-end anastomosis with the SCIA; however, no such cases have been reported to date. We assessed AIA diameter using computed tomography angiography (CTA) and analyzed six cases of SCIP flap transfer to the forearm using the AIA as the recipient vessel.

Methods

In 22 patients with traumatic hand or finger skin defects, we measured the diameters of the AIA and radial and ulnar arteries at the forearm center (point A) and distal quarter (point B) using CTA. Six cases of SCIP flap transfer to the forearm using the AIA as the recipient vessel were also analyzed. Defects were located in the distal part of the forearm in four cases, the middle part in one case, and the proximal part in one case, ranging from 5 × 10 to 12 × 16 mm².

Results

The AIA diameter (1.59 ± 0.05 mm at point A; 1.30 ± 0.07 mm at point B) was significantly smaller than that of the radial (2.64 ± 0.12 mm; 2.53 ± 0.10 mm) and ulnar arteries (2.25 ± 0.10 mm; 2.25 ± 0.09 mm) on CTA (p < 0.01). In the six surgical cases, the flap size ranged from 4.5 × 14.5 to 14 × 19 mm², and mean diameters of the anastomosed SCIA and AIA were 1.28 mm and 1.37 mm, respectively. The superficial circumflex iliac vein or SCIA accompanying vein was anastomosed to the cephalic vein. All flaps survived without postoperative circulatory complications.

Conclusion

The findings suggest that the AIA is suitable for end-to-end anastomosis with the SCIA.