title: Computed Tomography Angiography for Preoperative Thoracoabdominal Flap Planning.
abstract: Mastectomy rates have increased, coinciding with more advanced reconstruction options. Deep inferior epigastric perforator (DIEP) flaps decrease abdominal donor site morbidity, but require considerable technical expertise. Preoperative computed tomography angiography (CTA) can accurately demonstrate DIEA anatomy and perforator courses, facilitating preoperative planning and flap design, allowing for more targeted intraoperative microdissection. Patients who undergo CTA before DIEP flap have better clinical outcomes with shorter operative times and hospital length of stay, which can decrease overall associated health care costs. Future directions include selected imaging of the thoracic anatomy and recipient vasculature, allowing for additional preoperative planning and customization.
authors.affiliation: Department of Radiology, University of Washington Medical Center, 1959 Northeast Pacific Street, Box 357115, Seattle, WA 98195-7117, USA. Electronic address: ryanomal@uw.edu.
authors.forename: Ryan B
authors.initials: RB
authors.lastname: O'Malley
authors.affiliation: Seattle Radiologists, 1229 Madison Street, Suite 900, Seattle, WA 98104, USA.
authors.forename: Tracy J
authors.initials: TJ
authors.lastname: Robinson
authors.affiliation: Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0340, USA.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Kozlow
authors.affiliation: Cleveland Clinic, 9500 Euclid Avenue, L10-413, Cleveland, OH 44195, USA.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Liu
mesh_terms: D019074:Epigastric Arteries / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D016462:Mammaplasty; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods*; D017568:Rectus Abdominis / Q000098:blood supply* / Q000000981:diagnostic imaging; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed
keywords: Breast cancer; Breast reconstruction; Computed tomography angiography; Deep inferior epigastric perforator (DIEP) flap; Perforator-based flap