Matching the perforating branch of the internal thoracic artery and the deep inferior epigastric artery for breast reconstruction using multi-detector row computed tomography

Jpn J Radiol. 2022 Jun;40(6):624-629. doi: 10.1007/s11604-021-01235-0. Epub 2022 Jan 17.

Abstract

Purpose: Matching the diameter of the deep inferior epigastric artery (DIEA) and perforating branch (PB) of the internal thoracic artery (ITA) is important for arterial anastomosis during breast reconstruction using the DIEA flap. An anatomic investigation of these arteries was performed using multidetector row computed tomography (MDCT).

Patients and methods: Contrast-enhanced MDCT data of 50 women (aged 18-90 years) covering the neck to the groin were analyzed. The diameter of the PBs of the ITA at their origins from the first to the sixth intercostal space and of the DIEA 20 mm from the bifurcation of the external iliac artery were measured.

Results: The mean diameters of the right and left DIEAs were 1.53 ± 0.263 mm and 1.53 ± 0.306 mm, respectively. The diameter of the PBs in the second and third intercoastal spaces was the same as the diameter of the DIEA, bilaterally.

Conclusion: It is suggested that anastomosis of the DIEA with PBs of the ITA in the second and third intercoastal spaces is optimal for DIEA flap grafting. Our results could contribute to making vascular anastomosis easier, thereby reducing the burden on both surgeons and patients.

Keywords: Breast reconstruction; Computed tomography; Deep inferior epigastric artery; Internal thoracic artery; Perforating branch.

MeSH terms

  • Abdomen
  • Epigastric Arteries / diagnostic imaging
  • Epigastric Arteries / surgery
  • Female
  • Humans
  • Mammaplasty* / methods
  • Mammary Arteries* / diagnostic imaging
  • Mammary Arteries* / surgery
  • Multidetector Computed Tomography