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- “ The average estimated weight was 99.7% of the actual weight. The interquartile range (25th to 75th percentile) which represents the “middle half” of these patients was 91-109%, indicating that half of the patients had an estimated weight within 9% of the actual weight, however there was a large range (70-133%). ”
Three-Dimensional Computed Tomographic Angiography to Predict Weight and Volume of Deep Inferior Epigastric Artery Perforator Flap for Breast Reconstruction
Rosson GD, Shridharani SM,Flores JI, Fishman EK
Microsurgery 2011 Jul 18. doi: 10.1002/micr.20910. [Epub ahead of print] - “ 3D CTA with stereotactic fiducials allows surgeons to adequately estimate abdominal flap volume before surgery, potentially giving guidance in the amount of tissue that can be harvested from a patients lower abdomen.”
Three-Dimensional Computed Tomographic Angiography to Predict Weight and Volume of Deep Inferior Epigastric Artery Perforator Flap for Breast Reconstruction
Rosson GD, Shridharani SM,Flores JI, Fishman EK
Microsurgery 2011 Jul 18. doi: 10.1002/micr.20910. [Epub ahead of print] "Preoperative perforator flap planning for breast reconstruction utilizing 3D CT angiogram is safe, easy to read, and can change the operative plan."
3D CT angiography of abdominal wall vascular perforators to plan DIEAP flaps
Rosson GD, Williams CG, Fishman EK, Singh NK
Microsurgery 2007; 27(8);641-646"This article presents our first 23 flaps in 17 patients with preoperative ultra-high resolution 3D 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: Preoperative perforator flap planning for breast reconstruction utilizing 3D CT angiogram is safe, easy to read, and can change the operative plan"
3D CT angiography of abdominal wall vascular perforators to plan DIEAP flaps
Rosson GD, Williams CG, Fishman EK, Singh NK
Microsurgery 2007; 27(8);641-646- DIEP Flap Scanning Protocol
- 100 ml of Visipaque injected at 4 ml/sec
- Scanning done from 5 cm above umbilicus to lesser trochanter of hip
- Scan delay 30 seconds or trigger abdominal aorta at 180 HU on 64 MDCT, 220 HU on DS
- 0.75 mm thick sections reconstructed at .5 mm intervals "We also found a clear decrease in the number of post operative complications mainly partial necrosis of the flap. Partial necrosis of the flap diminished from 12% in the previous study of 100 patients to 2% in the 90 patients in the second phase of the study."
MDCT in the Preoperative Planning of Abdominal Perforator Surgery for Postmastectomy Breast Reconstruction
Clavero JA et al.
AJR 2008; 191:670-676"The ability to detect the dominant perforating artery preoperatively saves considerable time for the surgeon. In our series the time needed to elevate the flap was halved."
MDCT in the Preoperative Planning of Abdominal Perforator Surgery for Postmastectomy Breast Reconstruction
Clavero JA et al.
AJR 2008; 191:670-676"Before the use of MDCT in the preoperative planning of DIEP surgery, the elevation of the flap lasted an average of 4 hours, because this step included dissecting the inferior epigastric vessels, selecting the dominant perforating artery, and dissectng the dominant perforator artery."
MDCT in the Preoperative Planning of Abdominal Perforator Surgery for Postmastectomy Breast Reconstruction
Clavero JA et al.
AJR 2008; 191:670-676"The average operating time saved per patient was 1 hour 40 minutes and there was a significant reduction in postsurgical complications"
MDCT in the Preoperative Planning of Abdominal Perforator Surgery for Postmastectomy Breast Reconstruction
Clavero JA et al.
AJR 2008; 191:670-676"MDCT provides valuable information before surgery about the arterial anatomy of the inferior abdominal wall. It enables accurate identification of the most suitable dominant perforator vessel and makes surgical perforator flap procedures for breast reconstruction faster and safer."
MDCT in the Preoperative Planning of Abdominal Perforator Surgery for Postmastectomy Breast Reconstruction
Clavero JA et al.
AJR 2008; 191:670-676- DIEP Flap Planning
- Used for breast reconstructive surgery
- Main supply in abdominal perforator flaps is deep inferior epigastric artery
- deep inferior epigastric artery supplies perforators that go thru the rectus abdominis muscle