ArticleMicrosurgery2025
Real-Time Subcutaneous Arterial Navigation for Thinning of an Anterolateral Thigh Flap Using Photoacoustic Imaging and Projection Mapping: A Case Report.
Article in Microsurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
Thinning of anterolateral thigh flap is challenging. Anatomical studies have shown variations in arterial branching patterns in the subcutaneous layer, which were suspected to be the reason for the high frequency of thinning failures. We attempted to visualize subcutaneous arterial courses preoperatively and perform thinning of perforator flaps using this information appropriately. We accumulated evidence on the accuracy of noninvasive vascular visualization using photoacoustic tomography (PAT). In the present case, we applied a medical imaging projection system (MIPS), which enabled real-time surgical navigation using indocyanine green (ICG) emission signals, to use photoacoustic information intraoperatively during the flap thinning procedure. A 69-year-old woman underwent half-tongue resection using the pull-through method for right-sided tongue cancer. Preoperative PAT was performed 5 days before surgery. The 12 × 6-cm area took ~8 min to scan. We used an ICG test card containing ICG-positive control material cut into strips to show tentative artery lines by projection mapping. The transparent vascular map was laminated and sterilized. MIPS captured ICG fluorescence signals that penetrated the anterolateral thigh flap and continuously projected the purple area on the reverse side of the flap, guiding the position of the tentative arteries. A 20 × 6.5-cm anterolateral thigh flap was elevated with the distal part of the reconstructed tongue and proximal de-epithelialized part to fill the pull-thorough tunnel in the submandibular region. Active bleeding was observed when cutting marginal fat tissue near the purple line of the distal ALT flap projected by MIPS. The study protocol did not include a highly invasive trial for MIPS-guided thinning; therefore, we removed minimal marginal fat tissue. The ALT flap showed no postoperative complications while maintaining conversation and swallowing functions. We present the concept of subcutaneous arterial real-time navigation surgery using PAT and MIPS for safe, easy, and fast flap thinning procedures in the future.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.