Pathologic Patency Analysis of the Descending Branch of the Lateral Femoral Circumflex Artery in Head and Neck Reconstruction

The pathophysiology of atherosclerotic lesion progression shows that the composition of an atherosclerotic lesion is related to the clinical status of the patient. In humans, certain artery types, such as the coronary artery, renal artery, and internal carotid artery at the level of the carotid sinus and aorta, are prone to develop clinically manifested atherosclerosis, whereas other artery types remain free of atherosclerotic disease. In head and neck reconstruction, various flaps are used. Especially, anterolateral thigh free flap is a good option for reconstruction. The descending branch of the lateral femoral circumflex artery (DLFCA) is useful as an alternative arterial graft and pedicle for anterolateral thigh flaps. However, no pathophysiological study has determined whether the DLFCA is atherosclerosis resistant. The authors studied the morphological characteristics of the DLFCA and assessed the correlation with the degree of atherosclerotic change. Seventeen perforators originating from the DLFCA were selected. All sections were classified into 6 lesion types according to the American Heart Association. Seven sections contained a stenotic area of at least 25% and 1 section was > 50%. All sections were classified as type 1. In conclusion, the DLFCA only has physiological adaptation in the intimal layer and no relationship with atherosclerotic risk factors. Therefore, the DLFCA is atherosclerosis resistant and surgeons should not hesitate to use the DLFCA.