Document Detail


CT Angiography of Inferior Epigastric and Gluteal Perforating Arteries before Free Flap Breast Reconstruction.
MedLine Citation:
PMID:  21918046     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Muscle-sparing perforator free flap breast reconstruction with the use of an inferior epigastric or gluteal perforating artery to create a vascular pedicle is increasingly popular because it obviates breast implants and results in lower donor site morbidity than breast reconstruction with myocutaneous flaps. The tissue harvesting procedure for a perforator free flap involves dissecting the subcutaneous fat of the anterior abdominal wall or the buttock to locate and visually evaluate the perforating arteries so as to decide which one is most suitable for the vascular pedicle. The vessel selected depends on multiple anatomic and surgical considerations, and the decision-making process can be exceptionally time-consuming, in part because of the wide variation that occurs in vascular anatomy. Preoperative imaging can greatly improve the efficiency of the selection process. Doppler ultrasonography (US) is the most frequently used modality for vascular mapping, but the results are mixed because most perforating arteries have a diameter of less than 15 mm, the threshold for reliable visualization with US. A computed tomographic (CT) angiographic evaluation performed with the use of specific postprocessing and display techniques may be more accurate for identifying the most suitable vessel. CT angiography provides valuable information that can help optimize surgical planning, decrease time spent in the operating room, and improve the outcome of breast reconstruction surgery. © RSNA, 2011.
Authors:
Narayan Karunanithy; Victoria Rose; Adrian K P Lim; Adam Mitchell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiographics : a review publication of the Radiological Society of North America, Inc     Volume:  31     ISSN:  1527-1323     ISO Abbreviation:  Radiographics     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-09-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8302501     Medline TA:  Radiographics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1307-19     Citation Subset:  IM    
Affiliation:
Department of Interventional Radiology, Guy's & St Thomas' NHS Foundation Trust, London, England.
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