Anterior intercostal artery perforator flap in immediate breast reconstruction: Anatomical study and clinical application

Carrasco‐López, Cristian; Ibáñez, Juan Francisco Julián; Vilà, Jordi; Tomás, Miguel Ángel Luna; López, J.; Miguel, Iciar Pascual; Fernandez-Llamazares-Rodriguez, Jaime; Higueras-Suñe, Carmen

doi:10.1002/micr.30171

Cited by 35 publications

(43 citation statements)

References 25 publications

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“…Other potential advantages include avoiding a mastectomy and providing skin cover for reconstruction if needed. Although reported surgical and aesthetic outcomes have been encouraging, these are limited to few centers routinely performing these procedures [13][14][15][16][17][18]. In collaboration with three other centers, we set up a multicenter prospective database and report on surgical outcomes in patients who underwent BCS and partial breast reconstruction using ICAP flaps.…”

Section: Introductionmentioning

confidence: 99%

Chest wall perforator flaps for partial breast reconstruction: Surgical outcomes from a multicenter study

et al. 2020

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Background Perforator artery flaps based on the branches of intercostal arteries and lateral thoracic artery can be used for reconstruction after breast-conserving surgery (BCS). Although described more than a decade ago, these have not been adopted widely in clinical practice. We report on short-term and long-term surgical outcomes of partial breast reconstruction using chest wall perforator flaps from a prospective multicenter audit. Methods All patients operated for BCS and partial breast reconstruction using intercostal artery perforator or lateral thoracic artery perforator flaps from January 2015 to October 2018 were included in the analysis. Oncoplastic breast surgeons with appropriate level of training performed all tumor excisions and reconstructions as a single-stage procedure. Patient characteristics, treatment details and surgical outcomes were noted. Specific outcomes recorded were margin re-excision and complication rates. Results One hundred and twelve patients underwent the procedure in the given study period. The median age was 54 years. Median specimen weight was 62.5 g and median volume of excision was 121.4 mL. Fifteen patients (13.39%) underwent a margin re-excision for close or positive margins without additional morbidity. One patient required a completion mastectomy. Eight patients (7.14%) had an early complication. None of the patients required a contralateral symmetrization procedure. The results were comparable across the participating centers. Conclusions Chest wall artery perforator-based flaps are an excellent option for lateral and inferior quadrant partial breast reconstructions. The short and long-term surgical outcomes are comparable across sites and can be performed with minimal morbidity. Patient-reported outcome measures need to be studied.

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Section: Introductionmentioning

confidence: 99%

Chest wall perforator flaps for partial breast reconstruction: Surgical outcomes from a multicenter study

et al. 2020

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“…AICAP flaps are based on perforators originating from the rectus abdominis or oblique segment of the intercostal artery. 8 , 10 Cadaveric studies 11 and radiological studies 7 , 12 have demonstrated reliable and consistent location of perforator arteries.…”

Section: Discussionmentioning

confidence: 93%

“…AICAP flaps have been described in a V-Y or propeller fashion for the correction of small defects 13 ; they are especially useful in lower pole reconstructions for which other volume displacement or replacement techniques are challenging. 7 , 8 , 13 AICAP flaps have been shown to produce excellent cosmetic outcomes in immediate breast reconstruction. 7 The proposed technique allows larger defects to be reconstructed due to recruitment of larger volumes of tissue.…”

Section: Discussionmentioning

confidence: 99%

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The Modified Crescenteric Anterior Intercostal Perforator Flap

Denning

Hayes

Tsang

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…The chest wall perforator flaps (L-TAP and Li-CAP) can also be used as complete autologous flap reconstruction following mastectomy and was first described by Losken and Hamdi in 2009 [19,20]. This is a safe reconstruction option in the high-risk candidates, such as smokers, raised BMI, diabetics, or in patients where implant or complex autologous reconstructions are relatively contraindicated due to post-operative radiotherapy (Figures 20 and 21).…”

Section: Breast Cancer and Surgerymentioning

confidence: 99%

Oncoplastic Breast Surgery in the Treatment of Breast Cancer

Todd¹

2018

Breast Cancer and Surgery

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Breast cancer is one of the commonest cancers affecting women and oncoplastic breast surgery has been firmly established as the mainstay of modern surgical treatment, replacing the traditional two-operation approach. Careful patient selection, relevance of effective communication, patient education and navigating the complex decision-making process, are some of the topics covered in this chapter. Preoperative planning, implant selection, patient marking, importance of scar placement, marking and measuring the patient preoperatively, good theatre practice, technical tips for good cosmesis, and after care; are also discussed. A brief section on revision surgery following implant reconstruction, lipomodelling and a brief overview about breast implant associated anaplastic large cell lymphoma (BIA-ALCL) and multidisciplinary approach to modern management of breast cancer. It aims to serve as a guide to surgeons on current practice and achieving the ideal balance between oncological clearance of the cancer combined with good cosmesis and high levels of patient satisfaction.

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Anterior intercostal artery perforator flap in immediate breast reconstruction: Anatomical study and clinical application

Abstract: Based on this anatomical and clinical study, we found AICAP flap has a consistent vascularization with good perforators. And moreover, it is suitable for partial breast reconstruction (quadrantectomy) and does not appear to negatively impact patient satisfaction.

Cited by 35 publications

References 25 publications

Chest wall perforator flaps for partial breast reconstruction: Surgical outcomes from a multicenter study

Chest wall perforator flaps for partial breast reconstruction: Surgical outcomes from a multicenter study

The Modified Crescenteric Anterior Intercostal Perforator Flap

Oncoplastic Breast Surgery in the Treatment of Breast Cancer

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