Anatomical Study of Lumbar Artery Perforators in Male Subjects.

INTRODUCTION: The lumbar artery perforator (LAP) flap takes an important place in lumbosacral reconstruction and in breast reconstruction. Although studies on the location of lumbar perforators in women are common, no anatomical study has focused solely on male subjects. Our objective is to facilitate the surgical approach to the LAP flap in male subjects by precisely ascertaining the characteristics of the perforators. METHODS: We performed a retrospective review of computed tomographic angiography images of a cohort of 30 patients evaluating the perforator position from the 4 lumbar arteries. In addition, 4 characteristics were studied: the length, the diameter, the path of the lumbar pedicle, and the thickness of tissues available for transfer. RESULTS: One hundred five lumbar perforating vessels were analyzed on 60 posterior hemi-bodies, of which 86% came from the third and fourth lumbar arteries. The average location was situated 7.4 cm from the midline and in a 6-cm vertical wide area. The position of the lumbar perforator was independent of body mass index, abdominal circumference, and subject size. Our results, compared to previous studies, show no difference in this position between men and women. CONCLUSIONS: The LAP flap is useful for regional reconstructions and as a free flap for both women and men. We provide male-specific tracking values for the dissection of lumbar perforating vessels. Dominant perforators were found to be situated in a wide region of 4 cm × 6 cm in the lumbosacral region at 7.4 cm from the midline.

Balloon-occluded chemoembolization for hepatocellular carcinoma: a prospective study of safety, feasibility and outcomes.

AIM: Evaluation of safety and efficacy of selective balloon-occluded transarterial chemoembolization using polyethylene glycol embolizing microspheres in patients with hepatocellular carcinoma. MATERIALS & METHODS: Twenty-four consecutive patients were included in this monocentric prospective trial. Adverse events were evaluated at 24 h and 1 month. Imaging response according to modified response evaluation criteria in solid tumors was assessed at 1, 3 and 6 months. RESULTS: The median time of follow-up was of 22.8 months (interquartile range (IQR) 17.38-26.22). Clinical grade 1/2 toxicities (0% >grade 2) were reported in 25.7% of patients, with abdominal pain being the most frequent complication (17.1%). No 30-days mortalities or liver decompensation were observed. The 1-month follow-up MRI showed an overall response rate of 74.3%. CONCLUSION: Balloon-occluded transarterial chemoembolization was shown to be safe and effective.