Pathophysiology of progression of atherosclerotic lesions has shown that the composition of atherosclerotic lesions is related to the clinical status of the patient. Atheroscleorosis develops from first some regions with adaptive intimal thickening to advanced lesions. In human, certain artery types, such as the coronary artery, renal artery, internal carotid artery at the level of the carotid sinus and aorta are prone to develop clinically manifest atherosclerosis, while other artery types are considered to remain free to atherosclerotic disease. Between 2010 and 2013, 27 patients were performed anterolateral thigh flap for lower extremity reconstruction. After written informed consent was obtained from all patients, a preoperative angiography was performed by an experienced radiologist. 17 of 27 that the perforator was originated from DLFCA on angiography were selected. Patients’ atherosclerotic risk factors age, BMI, diabetes, hypertension, tobacco use, hyperlipidemia, cardiac status, carotid status, renal disease, pulmonary status, history of lower limb amputation were obtained in preoperative counseling. Area stenosis, a measure of the size of the intima in a cross-section corrected for arterial size, was calculated as (intimal area/IEL area) x 100%. All sections, obtained from the 17 patients, were classified according to AHA(American Heart Association) in six different types of lesions. The average lumen, IEL areas was 40.1±29.4mm2,49.6±34.7 mm2. The average area stenosis was 19.2±13.0%. 7 sections contained an area stenosis of at least 25% and 1 section exceeded 50%. All sections were classified as type1. All sections had just adaptive intimal thickening. The correlation coefficient between area stenosis and total score was -0.22(p=0.932). The correlation coefficient between area stenosis and age was 0.490(p