An angiosome is a three-dimensional unit of
skin
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation.
Other animal coverings, such as the arthropod exoskeleton, have different ...
and
underlying tissues vascularized by a source
artery
An artery () is a blood vessel in humans and most other animals that takes oxygenated blood away from the heart in the systemic circulation to one or more parts of the body. Exceptions that carry deoxygenated blood are the pulmonary arteries in ...
, termed an ''arteriosome'' and drained by a vein termed a ''venosome''. It is a concept that is used by
plastic surgeons, and other medical disciplines like CMF,
ENT
Ents are giant humanoids in J. R. R. Tolkien's fantasy world of Middle-earth who closely resemble trees; their leader is Treebeard of Fangorn forest. Their name is derived from an Old English word for "giant".
The Ents appear in ''The Lord ...
, etc., for the design and harvesting of
free flap
The terms free flap, free autologous tissue transfer and microvascular free tissue transfer are synonymous terms used to describe the "transplantation" of tissue from one site of the body to another, in order to reconstruct an existing defect. ...
transplants (e.g. fibula free-flap transplant), and by
vascular surgeons
Vascular surgery is a surgical subspecialty in which vascular diseases involving the arteries, veins, or lymphatic vessels, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolve ...
and
interventional radiologists for the
endovascular treatment of critical
limb ischemia
Acute limb ischaemia (ALI) occurs when there is a sudden lack of blood flow to a limb within 14 days of symptoms onset. On the other hand, when the symptoms exceed 14 days, it is called critical limb ischemia (CLI). CLI is the end stage of perip ...
. It is an alternative model to the traditional "best vessel" model.
An example is the angiosome of the
fibular artery
In anatomy, the fibular artery, also known as the peroneal artery, supplies blood to the lateral compartment of the leg. It arises from the tibial-fibular trunk.
Structure
The fibular artery arises from the bifurcation of tibial-fibular trunk ...
(also called the ''peroneal artery''), that primarily vascularizes the skin of the distal two-thirds of the
lateral-posterior aspect of the leg. Furthermore, also the underlying
fibula bone and parts of the local muscles, like the
flexor hallucis longus muscle
The flexor hallucis longus muscle (FHL) attaches to the plantar surface of phalanx of the great toe and is responsible for flexing that toe. The FHL is one of the three deep muscles of the posterior compartment of the leg, the others being the ...
.
Small arteries, called
arterial perforators, branch off from the larger arteries below the deep body
fascia
A fascia (; : fasciae or fascias; adjective fascial; ) is a generic term for macroscopic membranous bodily structures. Fasciae are classified as superficial, visceral or deep, and further designated according to their anatomical location.
...
. These arterial perforators penetrate the deep body fascia in their course towards the skin and further ramify in the
subcutaneous tissue
The subcutaneous tissue (), also called the hypodermis, hypoderm (), subcutis, or superficial fascia, is the lowermost layer of the integumentary system in vertebrates. The types of cells found in the layer are fibroblasts, adipose cells, and ma ...
. A three-dimensional unit of tissue, only encompassing skin and the subcutaneous tissue – but not the tissue from below the body fascia (like muscle and bone) – primarily supplied by a dominant arterial perforator, is called a ''perforasome''. Although multiple other arterial perforators may also supply this unit of tissue with arterial blood, it is the dominant arterial perforator that is essential for the survival of the perforasome.
Arterial perforators can be further defined by their path, in three categories: direct-cutaneous perforator, septo-cutaneous perforator and musculo-cutaneous perforator, depending on what anatomical structure the perforator progresses through, after branching from the deep source artery.
Therefore, generally speaking, one “big” angiosome can contain multiple “smaller” perforasomes.
References
Plastic surgery
Interventional radiology
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