Preoperative CT angiography versus Doppler ultrasound mapping of abdominal perforator in DIEP breast reconstructions: A randomized prospective study

Klasson, Stina; Svensson, Henry; Malm, Karl; Wassélius, Johan; Velander, Patrik

doi:10.1016/j.bjps.2015.02.002

Cited by 38 publications

(28 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thereafter, CTA was introduced in our clinic and performed in all patients between 2007-2010. From January 2011 to June 2013 patients were randomised in a prospective study either to US or CTA [13]. Based on findings on that study, patients operated between July 2013 and December 2014 had CTA only if they had earlier abdominal surgery with ensuing prominent scars.…”

Section: Methodsmentioning

confidence: 99%

Smoking increases donor site complications in breast reconstruction with DIEP flap

Klasson

Nyman

Svensson

et al. 2016

Journal of Plastic Surgery and Hand Surgery

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Smoking increases donor site complications in breast reconstruction with DIEP flap

Klasson

Nyman

Svensson

et al. 2016

Journal of Plastic Surgery and Hand Surgery

View full text Add to dashboard Cite

show abstract

“… Klasson et al 44 was graded as high risk of 'bias in selection of the reported results' given that there was one case lost to follow-up in the CTA group but incomplete data is still reported, and one case in the ultrasound group was excluded as the operation was very long and designated an outlier.…”

Section: Risk Of Biasmentioning

confidence: 99%

Perforator mapping reduces the operative time of DIEP flap breast reconstruction: A systematic review and meta-analysis of preoperative ultrasound, computed tomography and magnetic resonance angiography

Wade

Watford

Wormald

et al. 2018

Journal of Plastic, Reconstructive & Aesthetic Surgery

View full text Add to dashboard Cite

mapping reduces the operative time of DIEP flap breast reconstruction: a systematic review and meta-analysis of preoperative ultrasound, computed tomography and magnetic resonance angiography, Journal of Plastic, Reconstructive & Aesthetic Surgery (2017), https://doi.org/10.1016/j.bjps.2017.12.012. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Page 1 There are no other sources of funding to acknowledge. Conflicts of InterestThere are no conflicts of interest. Ethical reviewEthical review was not required as this is a review of published literature. Further, this article does not contain any studies with human participants, which were originally performed by any of the authors.

show abstract

“…The dominant perforator is the one selected in the vast majority of reconstructive cases, as it provides the best chance for flap survival [4]. If the ideal perforator is correctly identified preoperatively, the surgeon can sacrifice all other perforators, proceeding directly to the dominant one, significantly reducing operative time [7]. A shorter operative time lowers the risk of complications and the overall procedure cost [21].…”

Section: Discussionmentioning

confidence: 99%

“…The technique is noninvasive, safe, and has virtually no contraindications. Recent studies show no significant difference between Computer Tomography Angiography (CTA) and CDU in reducing operating times and lowering complication rates in patients undergoing breast reconstruction [7]. The main drawbacks associated with CDU are the long examination time and operator dependence [5].…”

Section: Introductionmentioning

confidence: 99%

Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators

et al. 2015

View full text Add to dashboard Cite

Aims: The high technical demands associated with perforator flaps demand a precise preoperative identification and evaluation of perforator vessels. Color Doppler Ultrasonography (CDU) and Dynamic Infrared Thermography (DIRT) are currently used for preoperative perforator mapping. Each individual technique has advantages and disadvantages. The purpose of this paper is to analyze the value of combining the two methods in order to optimize the process of preoperative perforator mapping. Material and methods: CDU and DIRT were used for preoperative perforator mapping in 10 pigs. The results were compared to intraoperative findings. Total number of perforators, localization, and identification of the dominant perforator was analyzed for each method. The examination time was recorded for each procedure. Results: Both methods had a high sensitivity in determining the number and localization of perforators when compared to those identified during surgery. DIRT produced a higher number of false positive results. CDU accurately identified the emergence of the perforators in the fascia in all cases. Both methods correctly identified the dominant perforator. The sensitivity, positive predictive value, and accuracy of CDU were 93.56%, 97%, and 91.30% respectively and for DIRT 95.05%, 80.67%, and 77.41% respectively. The average examination was 39.76 minutes for CDU and 10.24 minutes for DIRT. The average time taken into account for the analysis of a single perforator in order to confirm DIRT findings was 1.83 minutes. Conclusions: Preoperative perforator mapping has become a compulsory step in nearly all reconstructive procedures. In our study, both CDU and DIRT correctly identified the dominant perforator in all cases. By combining the two examinations overall mapping time can be reduced significantly. A reduced examination time translates into increased patient compliance and a lower procedure cost. The combined mapping technique facilitates the selection of the ideal perforator in all cases. Correctly identifying the dominant perforator preoperatively reduces operative time, lowers complication rates and ensures an overall better result.

show abstract

Preoperative CT angiography versus Doppler ultrasound mapping of abdominal perforator in DIEP breast reconstructions: A randomized prospective study

Cited by 38 publications

References 12 publications

Smoking increases donor site complications in breast reconstruction with DIEP flap

Smoking increases donor site complications in breast reconstruction with DIEP flap

Perforator mapping reduces the operative time of DIEP flap breast reconstruction: A systematic review and meta-analysis of preoperative ultrasound, computed tomography and magnetic resonance angiography

Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators

Contact Info

Product

Resources

About