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Incidental finding of subclavian artery occlusion and subsequent hypoplastic internal mammary artery as a candidate recipient vessel in diep flap breast reconstruction

Title
Incidental finding of subclavian artery occlusion and subsequent hypoplastic internal mammary artery as a candidate recipient vessel in diep flap breast reconstruction
Authors
Seong I.H.Woo K.-J.
Ewha Authors
우경제
Issue Date
2019
Journal Title
Archives of Plastic Surgery
ISSN
2234-6163JCR Link
Citation
Archives of Plastic Surgery vol. 46, no. 6, pp. 599 - 602
Keywords
AtherosclerosisBreast reconstructionFree flapInternal mammary arterySubclavian artery
Publisher
Korean Society of Plastic and Reconstructive Surgeons
Indexed
SCOPUS; KCI scopus
Document Type
Article
Abstract
We report a case of autologous breast reconstruction in which a thoracodorsal vessel was used as a recipient vessel after a hypoplastic internal mammary vessel was found on preoperative computed tomography (CT) angiography. A 46-year-old woman with no underlying disease was scheduled to undergo skin-sparing mastectomy and breast reconstruction using a deep inferior epigastric artery perforator flap. Preoperative CT angiography showed segmental occlusion of the right subclavian artery with severe atherosclerosis and calcification near the origin of the internal mammary artery, with distal flow maintained by collateral branches. The thoracodorsal artery was selected to be the recipient vessel because CT showed that it was of adequate size and was not affected by atherosclerosis. The patient experienced no postoperative complications, and the flap survived with no vascular complications. The breasts were symmetrical at a 6-month follow-up. This case highlights that preoperative vascular imaging modalities may help surgeons avoid using diseased vessels as recipient vessels in free flap breast reconstructions. © 2019, Korean Society of Plastic and Reconstructive Surgeons. All rights reserved.
DOI
10.5999/aps.2019.00430
Appears in Collections:
의과대학 > 의학과 > Journal papers
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