Preoperative computed tomography angiogram to predict XXXX with favorable anatomy for superficial inferior epigastric artery flap breast reconstruction.

@entity1 @entity7244
@entity7244 ( @entity7244 ) flap breast reconstruction has advantages over deep inferior epigastric perforator flap (DIEP) and muscle sparing transverse rectus abdominus myocutaneous flap (TRAM) reconstructions with less donor site morbidity and less complicated flap dissection. Not all @entity1 have an adequate @entity7244 and superficial inferior epigastric vein (SIEV) to support free tissue breast reconstruction, and dissection of the @entity7244 in all @entity1 can be time consuming. Preoperative computed tomography (CT) angiograms can be used to identify the @entity7244 and SIEV in @entity1 planning to undergo free abdominal tissue breast reconstruction and direct more efficient dissection in @entity1 with a large @entity7244 . Retrospective analysis of free abdominal tissue flap breast reconstruction from a single plastic surgeon was performed. All @entity1 undergoing free abdominal tissue breast reconstruction had a preoperative CT angiogram using a protocol for the evaluation of the abdominal wall perforating arteries. CT scans were reviewed by the surgeon preoperatively and evaluated for the presence, caliber, and image quality of the @entity7244 and SIEV. All @entity1 , regardless of CT angiogram findings, had operative dissection and evaluation of the @entity7244 and SIEV. A total of 177 free flaps were performed on 113 @entity1 who underwent preoperative CT angiogram and free abdominal tissue breast reconstruction. Of them, 64 @entity1 had bilateral breast reconstruction. Twelve @entity7244 flaps (10.6%) were performed on 12 @entity1 . During preoperative CT angiographic evaluation, 49 @entity1 (43%) were noted to have at least one visible @entity7244 , whereas only 24 of those @entity1 (21%) were felt to have an @entity7244 of adequate caliber. No flaps were lost during the postoperative period. All 12 @entity7244 flaps performed had an adequate @entity7244 when observed on preoperative CT angiogram. Overall, 50% of @entity1 found to have at least one adequate @entity7244 on CT angiogram had a single breast reconstructed with an @entity7244 flap. If the @entity7244 was not visualized on CT angiogram, no usable @entity7244 was found during surgery. Preoperative CT angiogram of the abdominal wall perforating arteries can help predict which @entity1 may have adequate anatomy for an @entity7244 -based free flap. This information may help direct more efficient dissection of the abdominal flaps by selecting out @entity1 who do not have an adequate @entity7244 .
