Three- and Four-Dimensional Arterial and Venous Perforasomes of the Internal Mammary Artery Perforator Flap

• DOI: 10.1097/prs.0b013e3181bf815f
• Publication Date: 2009-11-27T16:57:05Z
• Authors: Corrine Wong; Michel Saint-Cyr; Yvonne Rasko; Ali Mojallal; Steven Bailey; Simon Myers; Rod J. Rohrich
• Keywords: Mammary artery; Perforator flaps; Internal thoracic artery; Computed tomographic angiography; Intercostal arteries; Intercostal space

Background: The internal mammary artery perforator flap has been used in head and neck reconstruction. Although anatomical perfusion studies with ink have performed previously, the authors now use three- four-dimensional computed tomographic angiography to precisely visualize vascular anatomy of individual perforators (perforasomes) axiality perfusion. Methods: Eleven hemichest adipocutaneous flaps were dissected from cadavers. Measurements recorded, such as distance each sternal edge, diameter vessels, number location per hemichest. Single injections Isovue contrast carried out, subjected dynamic scanning. Static scanning was also undertaken using a barium-gelatin mixture. Images viewed both General Electric TeraRecon systems, allowing appreciation territory (three-dimensional), analysis flow (four-dimensional). Results: Each had one three perforators, most commonly intercostal spaces 1, 2, 3. Twenty-six dissected, 19 arteries six veins injected contrast. second space largest mean large territory. Linking direct indirect, communicate between can enlarge perforasomes. vessels found lateral thoracic artery. Conclusions: Three- allows detailed anatomy. Important information dimensions, linking is elucidated, thus contributing better understanding flaps.