Related Experiment Video
Updated: Aug 12, 2026
05:26
Two-Dimensional X-Ray Angiography to Examine Fine Vascular Structure Using a Silicone Rubber Injection Compound
Published on: January 7, 2019
6.0K
CT angiography prior to DIEP flap breast reconstruction: a randomized controlled trial
Salih Colakoglu1, Seth Tebockhorst2, Jonathan Freedman3
1Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, United States.
Summary
Preoperative CT angiogram (CTA) for deep inferior epigastric artery perforator (DIEP) flap breast reconstruction significantly reduces flap harvest and operating room time. This study confirms CTA
Area of Science:
- Microsurgical breast reconstruction
- Plastic and reconstructive surgery
- Medical imaging
Background:
- CT angiogram (CTA) is preferred for planning abdominal-based microsurgical breast reconstruction.
- CTA provides detailed perforator information, potentially reducing dissection and operating room time.
- High-level evidence supporting CTA utility was previously limited to nonrandomized studies.
Purpose of the Study:
- To evaluate the effectiveness of preoperative CTA in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction.
- To compare operative times and clinical outcomes between patients with and without preoperative CTA.
Main Methods:
- Prospective randomized study of patients undergoing DIEP flap breast reconstruction.
- Patients were randomized to receive preoperative CTA or no imaging.
- Data collected included operative times, perforator selection, and clinical outcomes. Statistical analysis used ANOVA, Fisher's exact, and Student's t-tests.
Main Results:
- Seventeen patients underwent preoperative CTA; 37 patients and 63 flaps were analyzed.
- Flap dissection time was significantly shorter in the CTA group (150.8 vs 184.7 minutes, p<0.001).
- Overall operative time was significantly shorter in the CTA group for bilateral surgeries (575.9 vs 641.9 minutes, p=0.038). Complication rates were similar.
Conclusions:
- Preoperative CTA analysis of perforators decreases flap harvest and overall operating room time.
- The study demonstrates equivalent postoperative outcomes between CTA and no-imaging groups.
- This prospective, randomized study provides high-level evidence for CTA's utility in DIEP flap breast reconstruction.
