Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction

Context: The internal mammary artery perforator vessels (IMPV) as a recipient in free flap breast reconstruction offer advantages over the more commonly used thoracodorsal vessels and the internal mammary vessels (IMV). Aims: This study was designed to assess the anatomical consistency of the IMPV a...

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Main Authors: Aditya V. Kanoi, Karnav B. Panchal, Saugata Sen, Gautam Biswas
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2017-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_168_16
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author Aditya V. Kanoi
Karnav B. Panchal
Saugata Sen
Gautam Biswas
author_facet Aditya V. Kanoi
Karnav B. Panchal
Saugata Sen
Gautam Biswas
author_sort Aditya V. Kanoi
collection DOAJ
description Context: The internal mammary artery perforator vessels (IMPV) as a recipient in free flap breast reconstruction offer advantages over the more commonly used thoracodorsal vessels and the internal mammary vessels (IMV). Aims: This study was designed to assess the anatomical consistency of the IMPV and the suitability of these vessels for use as recipients in free flap breast reconstruction. Patients and Methods: Data from ten randomly selected female patients who did not have any chest wall or breast pathology but had undergone a computed tomography angiography (CTA) for unrelated diagnostic reasons from April 2013 to October 2013 were analysed. Retrospective data of seven patients who had undergone mastectomy for breast cancer and had been primarily reconstructed with a deep inferior epigastric artery perforator free flap transfer using the IMPV as recipient vessels were studied. Results: The CTA findings showed that the internal mammary perforator was consistently present in all cases bilaterally. In all cases, the dominant perforator arose from the upper four intercostal spaces (ICS) with the majority (55%) arising from the 2nd ICS. The mean distance of the perforators from the sternal border at the level of pectoralis muscle surface on the right side was 1.86 cm (range: 0.9–2.5 cm) with a mode value of 1.9 cm. On the left side, a mean of 1.77 cm (range: 1.5–2.1 cm) and a mode value of 1.7 cm were observed. Mean perforator artery diameters on the right and left sides were 2.2 mm and 2.4 mm, respectively. Conclusions: Though the internal mammary perforators are anatomically consistent, their use as recipients in free tissue transfer for breast reconstruction eventually rests on multiple variables.
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spelling doaj-art-0eea9a6be0c94bc68aafc12a0823d7702025-08-20T01:59:13ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2017-01-01500105005510.4103/ijps.IJPS_168_16Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstructionAditya V. Kanoi0Karnav B. Panchal1Saugata Sen2Gautam Biswas3Department of Plastic and Reconstructive Surgery, TATA Medical Center, Kolkata, West Bengal, IndiaDepartment of Plastic and Reconstructive Surgery, TATA Medical Center, Kolkata, West Bengal, IndiaDepartment of Radiodiagnosis, TATA Medical Center, Kolkata, West Bengal, IndiaDepartment of Plastic and Reconstructive Surgery, TATA Medical Center, Kolkata, West Bengal, IndiaContext: The internal mammary artery perforator vessels (IMPV) as a recipient in free flap breast reconstruction offer advantages over the more commonly used thoracodorsal vessels and the internal mammary vessels (IMV). Aims: This study was designed to assess the anatomical consistency of the IMPV and the suitability of these vessels for use as recipients in free flap breast reconstruction. Patients and Methods: Data from ten randomly selected female patients who did not have any chest wall or breast pathology but had undergone a computed tomography angiography (CTA) for unrelated diagnostic reasons from April 2013 to October 2013 were analysed. Retrospective data of seven patients who had undergone mastectomy for breast cancer and had been primarily reconstructed with a deep inferior epigastric artery perforator free flap transfer using the IMPV as recipient vessels were studied. Results: The CTA findings showed that the internal mammary perforator was consistently present in all cases bilaterally. In all cases, the dominant perforator arose from the upper four intercostal spaces (ICS) with the majority (55%) arising from the 2nd ICS. The mean distance of the perforators from the sternal border at the level of pectoralis muscle surface on the right side was 1.86 cm (range: 0.9–2.5 cm) with a mode value of 1.9 cm. On the left side, a mean of 1.77 cm (range: 1.5–2.1 cm) and a mode value of 1.7 cm were observed. Mean perforator artery diameters on the right and left sides were 2.2 mm and 2.4 mm, respectively. Conclusions: Though the internal mammary perforators are anatomically consistent, their use as recipients in free tissue transfer for breast reconstruction eventually rests on multiple variables.http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_168_16computed tomography angiographyfree flap breast reconstructionhand-held dopplerinternal mammary perforatorsrecipient vessels
spellingShingle Aditya V. Kanoi
Karnav B. Panchal
Saugata Sen
Gautam Biswas
Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction
Indian Journal of Plastic Surgery
computed tomography angiography
free flap breast reconstruction
hand-held doppler
internal mammary perforators
recipient vessels
title Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction
title_full Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction
title_fullStr Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction
title_full_unstemmed Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction
title_short Computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction
title_sort computed tomography angiographic study of internal mammary perforators and their use as recipient vessels for free tissue transfer in breast reconstruction
topic computed tomography angiography
free flap breast reconstruction
hand-held doppler
internal mammary perforators
recipient vessels
url http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_168_16
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