ArticleAesthetic plastic surgery2025
Advancing Preoperative Planning in Perforator Flap Surgery with Photon-Counting Computed Tomography Angiography: Less Challenges with More Precision.
Article in Aesthetic plastic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The evolving role of computed tomography angiography in superficial circumflex iliac artery perforator flap mapping from anatomy to surgery: a systematic review.Surgical and radiologic anatomy : SRA · 2026Pooled it
- [A brief discussion on microsurgery techniques and free perforator flaps for wound repair].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2026Article
- Photon-Counting CT Angiography Enables Superior Preoperative Perforator Depiction for Fibular Transplant Surgery Requiring Less Contrast Agent Compared to Energy-Integrating CT.Diagnostics (Basel, Switzerland) · 2026Article
- Photon-Counting CT in Cardiovascular Imaging: Clinical Applications.Korean journal of radiology · 2026Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundPerforator flaps are crucial in plastic surgery, providing versatility in complex reconstructions. However, anatomical variations pose challenges in flap dissection and anastomosis. Conventional computed tomography angiography (CTA) is standard for preoperative planning but has limitations in evaluating small arteries. A novel technique, photon-counting computed tomography (PCCT), offers enhanced spatial resolution with lower radiation exposure.
methodsFrom December 2023 to September 2024, a pilot study was conducted at Peking Union Medical College Hospital in Beijing. Seven patients undergoing perforator flap reconstructions received preoperative PCCT angiography (experimental group). Five patients underwent conventional CTA scans (control group 1), and another five had flap reconstructions guided by traditional imaging methods (control group 2). Three flap types were analyzed: deep inferior epigastric perforator flap, anterolateral thigh perforator flap, and superficial circumflex iliac artery perforator flap. Imaging efficacy, radiation dose, and surgical outcomes were compared.
resultsPCCT identified significantly more perforators (14.5 ± 2.1 vs. 10.2 ± 1.8, p < 0.05) and smaller branch diameters (0.8 ± 0.1 mm vs. 1.2 ± 0.2 mm, p < 0.05) compared to conventional CTA. The radiation dose was lower with PCCT (6.3 ± 1.1 mSv vs. 8.1 ± 0.9 mSv, p < 0.05). The experimental group experienced shorter operation and flap harvesting times, with fewer complications than control group 2.
conclusionPCCT angiography enhances preoperative assessment of perforator vessels by detecting more and smaller perforators while reducing radiation exposure, thereby improving surgical planning and outcomes in perforator flap reconstructions. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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