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Ultrasonographic and color-flow Doppler ultrasonographic assessment of direct cutaneous arteries used for axial pattern skin flaps in dogs

Jennifer A. Reetz DVM, DACVIM1, Gabriela Seiler DrMedVet2, Philipp D. Mayhew BVM&S, DACVS3, and David E. Holt BVSc, DACVS4
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  • 1 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.
  • | 2 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.
  • | 3 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.
  • | 4 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

Abstract

Objective—To describe a method for ultrasonographic and color-flow Doppler ultrasonographic imaging of the 4 direct cutaneous arteries commonly used for axial pattern skin flaps in dogs.

Design—Descriptive report.

Animals—20 clinically normal dogs.

Procedures—Dogs were manually restrained and fundamental and harmonic ultrasonographic and colorflow Doppler ultrasonographic examinations of the superficial cervical, thoracodorsal, deep circumflex iliac (cranial and caudal branches), and caudal superficial epigastric arteries were performed by a resident in diagnostic imaging. The level of confidence in locating these vessels was subjectively graded as high, moderate, or low.

Results—High-frequency fundamental and harmonic ultrasonography was important for maximizing image resolution, and color-flow Doppler ultrasonography was important for vessel identification. The superficial cervical artery was the most difficult vessel to identify; confidence in correct vessel identification was low or moderate. The thoracodorsal and deep circumflex iliac arteries were identified with a moderate or high level of confidence. The caudal superficial epigastric artery was the easiest vessel to identify; confidence in correct vessel identification was high. Except for the superficial cervical artery, the level of confidence in correct vessel identification improved over time as operator experience increased.

Conclusion and Clinical Relevance—Results suggest that the combination of fundamental ultrasonographic and color-flow Doppler ultrasonographic imaging is an easy and noninvasive method for identifying the 4 direct cutaneous arteries commonly used for axial pattern skin flaps in dogs. This method could be useful in planning axial pattern skin flaps, particularly in dogs with regional soft tissue trauma in which the integrity of the vessel is in question.

Abstract

Objective—To describe a method for ultrasonographic and color-flow Doppler ultrasonographic imaging of the 4 direct cutaneous arteries commonly used for axial pattern skin flaps in dogs.

Design—Descriptive report.

Animals—20 clinically normal dogs.

Procedures—Dogs were manually restrained and fundamental and harmonic ultrasonographic and colorflow Doppler ultrasonographic examinations of the superficial cervical, thoracodorsal, deep circumflex iliac (cranial and caudal branches), and caudal superficial epigastric arteries were performed by a resident in diagnostic imaging. The level of confidence in locating these vessels was subjectively graded as high, moderate, or low.

Results—High-frequency fundamental and harmonic ultrasonography was important for maximizing image resolution, and color-flow Doppler ultrasonography was important for vessel identification. The superficial cervical artery was the most difficult vessel to identify; confidence in correct vessel identification was low or moderate. The thoracodorsal and deep circumflex iliac arteries were identified with a moderate or high level of confidence. The caudal superficial epigastric artery was the easiest vessel to identify; confidence in correct vessel identification was high. Except for the superficial cervical artery, the level of confidence in correct vessel identification improved over time as operator experience increased.

Conclusion and Clinical Relevance—Results suggest that the combination of fundamental ultrasonographic and color-flow Doppler ultrasonographic imaging is an easy and noninvasive method for identifying the 4 direct cutaneous arteries commonly used for axial pattern skin flaps in dogs. This method could be useful in planning axial pattern skin flaps, particularly in dogs with regional soft tissue trauma in which the integrity of the vessel is in question.

Contributor Notes

Supported by the Commonwealth of Pennsylvania.

The authors thank Patty O'Donnell for technical assistance.

Address correspondence to Dr. Reetz.