3D CT Angiography of Abdominal Wall Vascular Perforators to Plan DIEAP FlapsPurpose: Since the first report of TRAM flap reconstruction, there have been numerous studies to reduce complications of elective breast reconstruction. Current methods of pre-operative perforator localization can be time-consuming, inaccurate, and imprecise. Thus, we sought to evaluate ultra-high resolution 3D CT angiography for the pre-operative mapping of DIEAP flap perforating vessels.
Methods: We reviewed all perforator-based breast reconstructions performed over a 5 month period. Candidates for DIEAP flap reconstruction were sent for a focused CT scan of the abdominal wall, using the 64 slice multi-detector CT scanner.
Results: This paper presents our first 23 flaps in 17 patients with pre-operative ultra-high resolution 3-D CT angiography. The reconstruction plan changed in three patients (18%). There was one take-back for venous congestion, but no partial or total flap loss.
Conclusions: Pre-operative perforator flap planning for breast reconstruction utilizing 3D CT angiogram is safe, easy to read, and can change the operative plan.
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