Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Skeletal Radiology
Erschienen in: Skeletal Radiology 3/2013

01.03.2013 | Review Article

Preoperative imaging in the planning of deep inferior epigastric artery perforator flap surgery

verfasst von: Sébastien Aubry, Julien Pauchot, Adrian Kastler, Olivia Laurent, Yves Tropet, Michel Runge

Erschienen in: Skeletal Radiology | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

Breast reconstruction with adipocutaneous free flap from the abdominal wall combines the benefits of abdominoplasty to those of a prosthesis-free breast reconstruction. The deep inferior epigastric artery perforator (DIEP) flap is supplied by intramuscular perforators from the deep inferior epigastric artery (DIEA). It consists of the dissection of perforating branches of the DIEA within the rectus abdominis muscle, thus sparing both muscle and fascia. Preoperative imaging in the planning of DIEP flap surgery has been shown to facilitate faster and safer surgery. This review article aims to discuss advantages and drawbacks of current imaging modalities for mapping the course of perforating vessels in the planning of DIEP flap surgery, and to present state-of-the-art imaging techniques.
Literatur
1.
Hartrampf CR, Scheflan M, Black PW. Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg. 1982;69(2):216–25.PubMedCrossRef
2.
Granzow JW, Levine JL, Chiu ES, Allen RJ. Breast reconstruction using perforator flaps. J Surg Oncol. 2006;94(6):441–54.PubMedCrossRef
3.
Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg. 1994;32(1):32–8.PubMedCrossRef
4.
Moon HK, Taylor GI. The vascular anatomy of rectus abdominis musculocutaneous flaps based on the deep superior epigastric system. Plast Reconstr Surg. 1988;82(5):815–32.PubMedCrossRef
5.
Casey 3rd WJ, Chew RT, Rebecca AM, Smith AA, Collins JM, Pockaj BA. Advantages of preoperative computed tomography in deep inferior epigastric artery perforator flap breast reconstruction. Plast Reconstr Surg. 2009;123(4):1148–55.PubMedCrossRef
6.
Ghattaura A, Henton J, Jallali N, Rajapakse Y, Savidge C, Allen S, et al. One hundred cases of abdominal-based free flaps in breast reconstruction. The impact of preoperative computed tomographic angiography. J Plast Reconstr Aesthet Surg. 2010;63(10):1597–601.PubMedCrossRef
7.
Wong C, Saint-Cyr M, Mojallal A, Schaub T, Bailey SH, Myers S, et al. Perforasomes of the DIEP flap: vascular anatomy of the lateral versus medial row perforators and clinical implications. Plast Reconstr Surg. 2010;125(3):772–82.PubMedCrossRef
8.
Cina A, Salgarello M, Barone-Adesi L, Rinaldi P, Bonomo L. Planning breast reconstruction with deep inferior epigastric artery perforating vessels: multidetector CT angiography versus color Doppler US. Radiology. 2010;255(3):979–87.PubMedCrossRef
9.
Rozen WM, Palmer KP, Suami H, Pan WR, Ashton MW, Corlett RJ, et al. The DIEA branching pattern and its relationship to perforators: the importance of preoperative computed tomographic angiography for DIEA perforator flaps. Plast Reconstr Surg. 2008;121(2):367–73.PubMedCrossRef
10.
Giunta RE, Geisweid A, Feller AM. The value of preoperative Doppler sonography for planning free perforator flaps. Plast Reconstr Surg. 2000;105(7):2381–6.PubMedCrossRef
11.
Blondeel PN, Beyens G, Verhaeghe R, Van Landuyt K, Tonnard P, Monstrey SJ, et al. Doppler flowmetry in the planning of perforator flaps. Br J Plast Surg. 1998;51(3):202–9.PubMedCrossRef
12.
Hallock GG. Doppler sonography and color duplex imaging for planning a perforator flap. Clin Plast Surg. 2003;30(3):347-357, v-vi.
13.
Stupp T, Pavlidis M, Busse H, Thanos S. Presurgical and postsurgical ultrasound assessment of lacrimal drainage dysfunction. Am J Ophthalmol. 2004;138(5):764–71.PubMedCrossRef
14.
Phillips TJ, Stella DL, Rozen WM, Ashton M, Taylor GI. Abdominal wall CT angiography: a detailed account of a newly established preoperative imaging technique. Radiology. 2008;249(1):32–44.PubMedCrossRef
15.
Rozen WM, Phillips TJ, Ashton MW, Stella DL, Gibson RN, Taylor GI. Preoperative imaging for DIEA perforator flaps: a comparative study of computed tomographic angiography and doppler ultrasound. Plast Reconstr Surg. 2008;121(1 Suppl):1–8.PubMed
16.
Alonso-Burgos A, Garcia-Tutor E, Bastarrika G, Cano D, Martinez-Cuesta A, Pina LJ. Preoperative planning of deep inferior epigastric artery perforator flap reconstruction with multislice-CT angiography: imaging findings and initial experience. J Plast Reconstr Aesthet Surg. 2006;59(6):585–93.PubMedCrossRef
17.
Rozen WM, Ashton MW, Stella DL, Phillips TJ, Taylor GI. The accuracy of computed tomographic angiography for mapping the perforators of the DIEA: a cadaveric study. Plast Reconstr Surg. 2008;122(2):363–9.PubMedCrossRef
18.
Masia J, Clavero JA, Larranaga JR, Alomar X, Pons G, Serret P. Multidetector-row computed tomography in the planning of abdominal perforator flaps. J Plast Reconstr Aesthet Surg. 2006;59(6):594–9.PubMedCrossRef
19.
Rozen WM, Garcia-Tutor E, Alonso-Burgos A, Acosta R, Stillaert F, Zubieta JL, et al. Planning and optimising DIEP flaps with virtual surgery: the Navarra experience. J Plast Reconstr Aesthet Surg. 2010;63(2):289–97.PubMedCrossRef
20.
Vandevoort M, Vranckx JJ, Fabre G. Perforator topography of the deep inferior epigastric perforator flap in 100 cases of breast reconstruction. Plast Reconstr Surg. 2002;109(6):1912–8.PubMedCrossRef
21.
Blondeel PN, Arnstein M, Verstraete K, Depuydt K, Van Landuyt KH, Monstrey SJ, et al. Venous congestion and blood flow in free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps. Plast Reconstr Surg. 2000;106(6):1295–9.PubMedCrossRef
22.
Rozen WM, Anavekar NS, Ashton MW, Stella DL, Grinsell D, Bloom RJ, et al. Does the preoperative imaging of perforators with CT angiography improve operative outcomes in breast reconstruction? Microsurgery. 2008;28(7):516–23.PubMedCrossRef
23.
See MS, Pacifico MD, Harley OJ, Francis I, Smith RW, Jones ME. Incidence of ‘Incidentalomas’ in over 100 consecutive CT angiograms for preoperative DIEP flap planning. J Plast Reconstr Aesthet Surg. 2010;63(1):106–110.
24.
Rozen WM, Chubb D, Ashton MW, Webster HR. Mapping the vascular anatomy of free transplanted soft tissue flaps with computed tomographic angiography. Surg Radiol Anat. 2011.
25.
Chernyak V, Rozenblit AM, Greenspun DT, Levine JL, Milikow DL, Chia FA, et al. Breast reconstruction with deep inferior epigastric artery perforator flap: 3.0-T gadolinium-enhanced MR imaging for preoperative localization of abdominal wall perforators. Radiology. 2009;250(2):417–24.PubMedCrossRef
26.
Newman TM, Vasile J, Levine JL, Greenspun DT, Allen RJ, Chao MT, et al. Perforator flap magnetic resonance angiography for reconstructive breast surgery: a review of 25 deep inferior epigastric and gluteal perforator artery flap patients. J Magn Reson Imaging. 2010;31(5):1176–84.PubMedCrossRef
27.
Neil-Dwyer JG, Ludman CN, Schaverien M, McCulley SJ, Perks AG. Magnetic resonance angiography in preoperative planning of deep inferior epigastric artery perforator flaps. J Plast Reconstr Aesthet Surg. 2009;62(12):1661–5.PubMedCrossRef
28.
Rozen WM, Stella DL, Bowden J, Taylor GI, Ashton MW. Advances in the pre-operative planning of deep inferior epigastric artery perforator flaps: magnetic resonance angiography. Microsurgery. 2009;29(2):119–23.PubMedCrossRef
Metadaten
Titel
Preoperative imaging in the planning of deep inferior epigastric artery perforator flap surgery
verfasst von
Sébastien Aubry
Julien Pauchot
Adrian Kastler
Olivia Laurent
Yves Tropet
Michel Runge
Publikationsdatum
01.03.2013
Verlag
Springer-Verlag
Erschienen in
Skeletal Radiology / Ausgabe 3/2013
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-012-1461-y

Weitere Artikel der Ausgabe 3/2013

Skeletal Radiology 3/2013 Zur Ausgabe

Case Report

Multifocal giant cell tumor of the tendon sheath: case report and literature review

Scientific Article

Sublabral clefts and recesses in the anterior, inferior, and posterior glenoid labrum at MR arthrography

OriginalPaper

Ultrasound scanning for recalcitrant plantar fasciopathy. Basis of a new classification

Scientific Article

Assessment of the diagnostic value of dual-energy CT and MRI in the detection of iatrogenically induced injuries of anterior cruciate ligament in a porcine model

Scientific Article

Reports of magnetic resonance images of the hip in patients with femoroacetabular impingement: is useful information provided to the orthopedic surgeon?

Scientific Article

Cam type femoro-acetabular impingement: quantifying the diagnosis using three dimensional head-neck ratios

Neu im Fachgebiet Radiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise