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The Significance of Preoperative CT Angiography in Breast Reconstruction with DIEA Perforator Flaps

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Breast Reconstruction

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Abstract

Autologous breast reconstruction with abdominal perforator flaps has become a standard procedure in plastic surgery for treatment of mastectomy patients. From a surgical view of point the main limitation of using a DIEAP flap for breast reconstruction is the existence and availability of at least one perforator artery which can supply the flap with arterial blood. Finding the dominant or one of the dominant perforators when raising the flap is surgically demanding as the anatomy of the DIEA can vary from patient to patient and also from the right to the left hemi-abdomen dramatically. Imaging and mapping techniques have been developed to optimize the planning of perforator flap surgery and facilitate the dissection. The preoperative CT angiography displaced the Doppler Ultrasonography and the color Duplex Ultrasonography due to several reasons which are highlighted here. Particularly the CTA helped developing classifications for DIEA branching patterns and 3-dimensional perforator courses helping in choosing the right perforator(s).

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Authors and Affiliations

  1. Clinics for Plastic Surgery and Hand Surgery at Klinikum Rechts der Isar, Technical University Munich, Ismaninger Str. 22, Munich, 81675, Germany

    Haydar Kuekrek M.D., Hans-Günther Machens M.D. & Daniel Mueller M.D.

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  1. Haydar Kuekrek M.D.
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  2. Hans-Günther Machens M.D.
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  3. Daniel Mueller M.D.
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Correspondence to Haydar Kuekrek M.D. .

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  1. Tustin, California, USA

    Melvin A. Shiffman

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Kuekrek, H., Machens, HG., Mueller, D. (2016). The Significance of Preoperative CT Angiography in Breast Reconstruction with DIEA Perforator Flaps. In: Shiffman, M. (eds) Breast Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-18726-6_13

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  • DOI: https://doi.org/10.1007/978-3-319-18726-6_13

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