Few studies have been developed to map the vascular structures feeding peripheral nerves, with the majority using cadaveric models and inadequate sample sizes. Preliminary evidence, while limited, indicates that the mapping of these vessels may allow or preclude certain procedures in nerve reconstruction due to the location of essential arterial inflow to the vasa nervorum. This review evaluates the evidence regarding historical, current, and emerging techniques for visualizing these vascular structures in vivo and considers their potential application in peripheral nerve vasculature.

Among imaging techniques used to visualize nerve vasculature, contrast enhanced magnetic resonance angiography (CE-MRA) and laser angiography show potential for mapping common perforating vessels and visualizing these structures in individuals, respectively.

Essentials:

1. Adequate vascular perfusion is necessary for normal nerve function and regeneration of injured nerves. Yet, the literature is lacking in assessments of techniques for visualizing nerve vasculature.

2. Mapping of common perforating vessels and imaging of these structures in individual patients may enable surgeons to better preserve blood flow, allowing for improved patient outcomes.

3. Ultrasound/Doppler, optical coherence tomography (OCT), and laser angiography are most useful in a clinical setting to visualize superficial structures, with laser angiography showing the most potential benefit for intraoperative imaging. While various MR techniques have been used to visualize nerve vasculature, CE-MRA may provide the greatest utility for mapping common perforating vessels of the peripheral nerves.

Received: 10 September 2020

Accepted: 31 March 2021

Publication Date:
23 July 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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