Gregory Aaron Bonci MD, Presenter: Nothing to Disclose

Bohdan Pomahac MD, Abstract Co-Author: Nothing to Disclose

Dimitris Mitsouras PhD, Abstract Co-Author: Nothing to Disclose

Stephanie A. Caterson MD, Abstract Co-Author: Nothing to Disclose

Amir Imanzadeh MD, Abstract Co-Author: Nothing to Disclose

Meaghan Mackesy MD, Abstract Co-Author: Nothing to Disclose

Edward J. Caterson MD, PhD, Abstract Co-Author: Nothing to Disclose

Frank John Rybicki MD, PhD, Abstract Co-Author: Research Grant, Toshiba Corporation

Perforator flaps offer cosmetically superior results with significantly less morbidity than TRAM flaps. Choice of flap is dependent on patient anatomy and quality of vasculature. Pre-operative CTA effectively maps perforators, decreases operative time, and decreases morbidity/complications. Post-processing may also help to determine exact tissue volume to be harvested for more targeted reconstruction.  

1. Autologous breast reconstruction basics (patient selection, aim, timing of surgery, advantages over breast implants). 2. Overview and evolution of flap options with focus on deep inferior epigastric perforator (DIEP) and superior gluteal artery perforator (SGAP) flaps. 3. Overview of pre-operative imaging including Doppler ultrasound, CTA, and MRA. Brief review of literature demonstrating the advantages of CTA with regard to duration of surgery, length of hospitalization, and complication rates. 4. Importance of angiosomes in perforator flap surgery. Alteration of imaging protocols to better determine flap vascular supply and reduce likelihood of fat necrosis. 5. Future directions include 3D printing of perforator flaps for more customized pre-operative planning.  

http://abstract.rsna.org/uploads/2014/14009475/14009475_1hn8.pdf

Bonci, G, Pomahac, B, Mitsouras, D, Caterson, S, Imanzadeh, A, Mackesy, M, Caterson, E, Rybicki, F, Breast Reconstruction with DIEP and SGAP Flaps – Role of Pre-Operative CT Angiogram.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009475.html