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Int J Angiol 2016; 25(05): e87-e88
DOI: 10.1055/s-0034-1390085
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Using a Single Internal Mammary Artery as Retrograde and Antegrade Flow for Bilateral Deep Inferior Epigastric Artery Perforator Reconstruction: A Case Report

Richard Tyrell
1   Department of General Surgery, North Shore-Long Island Jewish Health System, Hofstra University School of Medicine, Hempstead, New York
,
Rachelle Y. Leong
1   Department of General Surgery, North Shore-Long Island Jewish Health System, Hofstra University School of Medicine, Hempstead, New York
,
Sandeep A. Sathyanarayana
1   Department of General Surgery, North Shore-Long Island Jewish Health System, Hofstra University School of Medicine, Hempstead, New York
,
Peter Korn
1   Department of General Surgery, North Shore-Long Island Jewish Health System, Hofstra University School of Medicine, Hempstead, New York
,
Alan S. Kadison
1   Department of General Surgery, North Shore-Long Island Jewish Health System, Hofstra University School of Medicine, Hempstead, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2014 (online)

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Abstract

Deep inferior epigastric artery perforator (DIEP) flaps have become an attractive option for autologous breast reconstruction. The internal mammary artery (IMA) is the usual artery of choice for reconstruction. Unfortunately, there are certain situations when the IMA may not be suitable for usage as in previous radiation or diminutive size. Several options have been documented, such as using the thoracodorsal vessels. In this case report, we report usage of the distal and proximal ends of a contralateral single mammary artery to supply antegrade and retrograde flow to bilateral DIEP flaps. With increasing complexity of patient populations, the use of alternate approaches to recipient vessel in DIEP reconstruction becomes essential for effective outcomes.

Keywords

DIEP - internal mammary artery - antegrade - retrograde - breast reconstruction
 

  • References

  • 1 Atisha D, Alderman AK. A systematic review of abdominal wall function following abdominal flaps for postmastectomy breast reconstruction. Ann Plast Surg 2009; 63 (2) 222-230
    CrossrefPubMedGoogle Scholar
  • 2 Cohen-Hayoun E, Pessis R, Lkah C, Atlan M. Strategies in case of unusable internal mammary vessels in a mammary reconstruction by DIEP. Ann Chir Plast Esthet 2013; 58 (1) 69-73
    CrossrefPubMedGoogle Scholar
  • 3 Hamdi M, Khuthaila DK, Van Landuyt K, Roche N, Monstrey S. Double-pedicle abdominal perforator free flaps for unilateral breast reconstruction: new horizons in microsurgical tissue transfer to the breast. J Plast Reconstr Aesthet Surg 2007; 60 (8) 904-912 , discussion 913–914
    CrossrefPubMedGoogle Scholar
  • 4 Chan RK, Przylecki W, Guo L, Caterson SA. Case report. The use of both antegrade and retrograde internal mammary vessels in a folded, stacked deep inferior epigastric artery perforator flap. Eplasty 2010; 10: e32
    PubMedGoogle Scholar
  • 5 Barabás AG, Shafighi M, Sassoon EM, Haywood RM. The bilateral DIEP flap: a method of bipedicled anastomosis to a single internal mammary artery and venae comitantes. J Plast Reconstr Aesthet Surg 2008; 61 (10) 1249-1251
    CrossrefPubMedGoogle Scholar
  • 6 Apostolides JG, Magarakis M, Rosson GD. Perserving the internal mammary artery: End-to-side microvascular arterial anastomosis for DIEP and SIEA flap breast reconstruction. Plast Reconstr Surg 2011; 128 (4) 225e-232e
    CrossrefPubMedGoogle Scholar