{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:46:08Z","timestamp":1791902768355,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reliable localization of septocutaneous fibular artery perforators is essential for fibula free flap planning. However, the influence of lower\u2010leg vascular anatomy on perforator number and spatial distribution remains unclear. This study aimed to analyze perforator number and spatial distribution using computed tomography angiography (CTA) with both fibula\u2010 and artery\u2010based reference systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, patients undergoing lower\u2010extremity CTA before mandibular continuity resection were screened. Parameters included run\u2010off status, Kim classification, vascular anomalies, atherosclerotic plaque, and morphometric characteristics of the fibula and fibular artery. Perforator number per limb and relative perforator position were assessed using fibula\u2010 and artery\u2010based reference systems. Associations were evaluated using nonparametric tests and multivariable regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 491 limbs from 247 patients were included, yielding 812 septocutaneous perforators. Limbs with fibular artery stenosis showed fewer perforators compared with limbs without stenosis (median 0.5 [0\u20132] vs. 2 [1\u20132],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Perforator distribution was nonuniform in both reference systems, with clustering in mid\u2010segments (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Notably, spatial distribution patterns differed depending on the reference system used. In multivariable analyses, non\u20101A Kim run\u2010off classification was associated with a more proximal perforator position along the fibula (\u03b2\u2009=\u2009\u221210.0 percentage points,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas no limb\u2010level factor was associated with artery\u2010referenced perforator position, indicating greater stability of artery\u2010based mapping.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Septocutaneous fibular artery perforators show reference\u2010dependent spatial variability. Fibular artery stenosis is associated with fewer perforators, whereas only Kim run\u2010off classification affects fibula\u2010referenced location. These findings support artery\u2010based mapping for fibula flap planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70266","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:52:56Z","timestamp":1784094776000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Computed Tomography Angiography\u2010Based Mapping of Septocutaneous Fibular Artery Perforators: An Anatomical Analysis"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5520-4635","authenticated-orcid":false,"given":"Jannik","family":"Ketschau","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery TUM University Hospital Klinikum Rechts der Isar, School of Medicine and Health, Technical University of Munich  Munich 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