Summary
Background
The posterior intercostal artery (PICA) is divided into four segments, vertebral,
costal, intermuscular, and rectus, based on the neurovascular branching pattern. Dorsal
branches arise from the vertebral segment. Several musculocutaneous perforators and
a lateral branch originate from the costal segment. Musculocutaneous branches arise
from the intermuscular and rectus segments. The purpose of this study is to describe
in detail the musculocutaneous perforators of the costal segment of the posterior
intercostal artery.
Methods
Fresh cadavers were injected with a modified lead oxide–gelatin mixture. Intercostal
spaces (8–11) were dissected in twelve cadavers (six preserved cadavers and six fresh
cadavers). Angiograms were assembled with Adobe Photoshop. Two fresh cadavers underwent
CT angiography and three dimensional reconstructions of the intercostal perforators
were performed using Materialise's Interactive Medical Image Control System (MIMICS).
Results
In twelve cadavers, a total of 356 perforators (size > 0.5 mm) were found to arise
from the posterior intercostal arteries in 96 intercostal (IC) spaces. 154 perforators
(>0.5 mm) were found in the costal segment of the PICA. An average of 6.4 perforators
was found in each hemithorax. All perforators were found within 2 cm of the midscapular
line. At least one perforator was found in all intercostal spaces. Two or more perforators
were found in 40% of the 8th and 9th IC spaces and 60% of the 10th and 11th IC spaces.
Perforators were oriented perpendicular to the direction of the muscle fibres of the
latissimus dorsi and were usually present one or two intercostal spaces below their
origin from the PICA.
Conclusions
Perforators of the costal segment of the PICA are described in detail. We propose
to call these currently unnamed musculocutaneous perforators “dorsolateral” branches
of the PICA, as they are located between dorsal and lateral branches of PICA.
Keywords
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Article info
Publication history
Published online: June 11, 2012
Accepted:
May 18,
2012
Received:
January 18,
2012
Footnotes
☆Presented on October 28, 2010 at the XIIIth International Perforator Flap Meeting, Mexico City, Mexico and on May 26, 2011 at the 16th Congress of the International Confederation for Plastic Reconstructive and Aesthetic Surgery (IPRAS), Vancouver, Canada.
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
