Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
4119993 | Journal of Plastic, Reconstructive & Aesthetic Surgery | 2009 | 5 Pages |
Abstract
Accurate preoperative localisation of deep inferior epigastric artery perforator (DIEaP) provides optimal surgical planning for DIEaP flaps. Cross-sectional imaging by contrast-enhanced magnetic resonance angiography (CE-MRA) has advantages over previously described techniques for perforator imaging including reduced radiation exposure and better muscle to vessel contrast. A retrospective series of 10 unilateral free breast reconstructions following preoperative CE-MRA of the anterior abdominal wall is presented. Mean age of the patients at the time of surgery was 50.3 years (range 44-63 years). An average of 2.8 perforators per study (range 1-5) was identified. Mean perforator luminal diameter was 2.6Â mm (1.4-4.0Â mm) with a mean intramuscular course length of 22.3Â mm (6.4-51.9Â mm). Perforator course length was classified as 17% long intramuscular course (>4Â cm), 80% short intramuscular course (<4Â cm) and 3% paramedian. In all 10 patients, DIEaP flaps were successfully elevated. In all cases the flaps were elevated on vessels identified in preoperative review of the CE-MRA. There was a significant difference in the rates of conversion from DIEaP to transverse rectus abdominis myocutaneous (TRAM) flaps in the group who underwent CE-MRA in comparison to historical controls from the previous year (PÂ =Â 0.025). CE-MRA is an effective tool for DIEaP flap planning.
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Authors
J.G. Neil-Dwyer, C.N. Ludman, M. Schaverien, S.J. McCulley, A.G.B. Perks,