Document Detail


The retrograde limb of the internal mammary vein: an additional outflow option in DIEP flap breast reconstruction.
MedLine Citation:
PMID:  19730291     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The deep inferior epigastric perforator (DIEP) flap has become an increasingly popular option for postmastectomy reconstruction. The purpose of this study was to evaluate the retrograde limb of the internal mammary vein as a recipient vein in DIEP breast reconstruction.
METHODS: Fifteen consecutive DIEP flaps in 13 patients were transferred with anastomosis of one DIEP vena comitans to the antegrade internal mammary vein and the other DIEP vena comitans to the retrograde internal mammary vein. The deep inferior epigastric artery was anastomosed to the antegrade internal mammary artery. Blood flow through the retrograde internal mammary vein was evaluated with intraoperative duplex ultrasound.
RESULTS: Thirty venous anastomoses in 15 DIEP flaps for breast reconstruction were performed over a 4-month period to investigate the retrograde limb of the internal mammary vein as a potential recipient vein. No evidence of intraoperative venous congestion was seen. Retrograde blood flow was demonstrated using intraoperative duplex imaging and clinical examination. All 15 flaps were successful.
CONCLUSIONS: The retrograde limb of the internal mammary vein is an option as a recipient vein in DIEP breast reconstruction. This outflow option may prove useful in cases with intraoperative congestion in a single vein flap, in cases with co-dominant superficial and deep venous systems, and in cases in which double-pedicle free flaps are used for unilateral breast reconstruction.
Authors:
Mahlon A Kerr-Valentic; Lawrence J Gottlieb; Jayant P Agarwal
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  124     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-04     Completed Date:  2009-09-23     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  717-21     Citation Subset:  AIM; IM    
Affiliation:
University of Utah School of Medicine, Salt Lake City, Utah 84132, USA. jay.agarwal@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anastomosis, Surgical
Female
Humans
Intraoperative Period
Mammaplasty / methods*
Mastectomy*
Middle Aged
Regional Blood Flow
Reoperation
Surgical Flaps / blood supply*
Thorax / blood supply
Ultrasonography, Doppler, Duplex
Veins / surgery
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2010 Apr;125(4):1298-9; author reply 1299   [PMID:  20335891 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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