A subfascial variant of the deep inferior epigastric artery demonstrated by preoperative multidetector computed tomographic angiography: a case report.
Precise preoperative imaging by multidetector computed tomographic (MDCT) angiography for planning of deep inferior epigastric artery perforator (DIEP) flap dissection has been reported for enormous advantages in terms of reduced operative time and minimized flap-related complications. This case report shows a particularly rare anatomical subfascia variant of deep inferior epigastric artery (DIEA) which can be preoperatively demonstrated by MDCT angiogram. Therefore, the intraoperative finding also confirms the radiologic data and results in meticulous flap harvesting during incision on anterior rectus sheath. Additionally, the authors emphasize on performing preoperative high quality imaging for DIEP intervention precisely for specific vulnerable course of subfascial plane DIEP, which is rare but tends to be at risk without foreknowing its exact course.
Division of Plastic Surgery, European Institute of Oncology, 435-20141 Milano, Italy. cristina.garusi@ieo.it
Cristina
C
Garusi
Visnu
V
Lohsiriwat
Francesca
F
de Lorenzi
Andrea
A
Manconi
Elvio
E
de Fiori
Massimo
M
Bellomi
D034861:Abdominal Wall / Q000098:blood supply*; D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D019074:Epigastric Arteries / Q000002:abnormalities*; D005205:Fascia / Q000098:blood supply; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008866:Microsurgery; D011300:Preoperative Care; D013524:Surgical Flaps / Q000098:blood supply*; D014057:Tomography, X-Ray Computed