An anatomical study of the superficial inferior epigastric vessels in humans

Reardon, Caitlin M.; O’Ceallaigh, Siobhan; O'Sullivan, SS

doi:10.1016/j.bjps.2004.04.019

Cited by 91 publications

(76 citation statements)

References 9 publications

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“…This may be accomplished by anastomosing the superficial vein to an internal mammary vein perforator (IMVP),a secondary IMV, to the distal end of the IMV in a retrograde fashion, to the deep system directly, or even to the basilic vein [20][21][22]. The SIEV is present in 95% of patients, and preservation of this vein can be very beneficial with minimal additional operative time and morbidity [23].…”

Section: Discussionmentioning

confidence: 99%

Double Venous System Drainage in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Boutros¹,

Martínez²

2016

Breast Reconstruction

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Section: Discussionmentioning

confidence: 99%

Double Venous System Drainage in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Boutros¹,

Martínez²

2016

Breast Reconstruction

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“…По данным M. Fathi et al [12], C. M. Reardon et al [9], час-тота встречаемости поверхностной надчрев-ной артерии достигает 100%. В исследованиях E. Fukaya et al [8] поверхностная надчревная артерия наблюдалась в 65%.…”

Section: результаты и их обсуждениеunclassified

“…Данные литературы свидетельствуют о том, что хорошее приживление «SIEA» лоску-та достигается лишь в тех случаях, когда рас-стояние между сосудами составляет не более 1.8 см [1,9]. По данным проведенного иссле-дования, расстояние между поверхностной надчревной артерией и веной на уровне пахо-вой связки составило 1.6±0.5 см.…”

Section: результаты и их обсуждениеunclassified

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Variant Anatomy of Superficial Epigastric Vessels and their Significance in Breast Reconstructive Surgery After Mastectomy

Черных¹,

Закурдаев²,

Yakusheva³

et al. 2017

JAH

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Исследовано 40 нефиксированных трупов лиц женского пола, умерших в возрасте 53.8±4.4 лет. На аутопсии трупов изучали топографию поверхностных надчревных сосудов. В исследованном секционном материале поверхностная надчревная артерия с обеих сторон отмечена в 70%, а вена -в 100% наблюдений. В 10% поверхностная надчревная артерия отсутствовала с обеих сторон, в 20% -отмечалась с одной сто-роны, чаще слева (75%). Относительно середины паховой связки поверхностная надчревная артерия все-гда располагалась латерально (0.8±0.2 см), а вена -медиально (0.9±0.1 см). Расстояние между поверхно-стной надчревной артерией и веной на уровне паховой связки составило 1.6±0.5 см. Диаметр поверхност-ной надчревной артерии на уровне паховой связки составил 1.7±0.2 мм, а вены -2.1±0.4 мм. We studied 40 cadavers of females who died at the age of 53.8±4.4 years. At autopsy of cadavers we studied the topography of superficial epigastric vessels. In investigated section material superficial epigastric artery was observed on both sides in 70% and vein -in 100% of cases. In 10% the superficial epigastric artery was absent on both sides. In 20% superficial epigastric artery was observed on one side, more often -left (75%). Regarding the middle of the inguinal ligament the superficial epigastric artery is always positioned laterally (0.8±0.2 cm), and vein -medially (0.9±0.1 cm). The distance between the superficial epigastric artery and the vein at the level of the inguinal ligament was 1.6±0.5 cm. Diameter of superficial epigastric artery at the level of the inguinal ligament was 1.7±0.2 mm and vein -2.1±0.4 mm.

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“…The highest reported rate of use of the SIEA flap versus the DIEA-based flaps has been in the 30% range (3,5,8,9). Yet, the presence of the SIEA and venea, and the SIEV of sufficient calibre has been documented in anatomical studies to be available in nearly 75% of cases (10).…”

mentioning

confidence: 99%

Rethinking the superficial inferior epigastric artery flap in breast reconstruction: Video demonstration of a rapid, reliable harvest technique

Buchel

Dalke

Hayakawa

2013

Canadian Journal of Plastic Surgery

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T he majority of autologous free flap breast reconstruction uses tissue from the lower anterior abdominal wall. Traditionally, this involved harvesting the entire ipsilateral or bilateral rectus abdominus muscles while incorporating them into the transverse rectus abdominus flap (TRAM flap). Recently, lower abdominal wall flap elevation has evolved from complete rectus abdominus muscle resection to limited muscle harvest and finally to perforator flap harvest. The deep inferior epigastric artery perforator (DIEP) flap is now considered to be one of the least debilitating harvest techniques routinely used in breast reconstruction. This perforator flap uses the deep inferior epigastric artery and venea comitantes to perfuse varying degrees of the lower abdominal wall skin and fat, without intentional harvest or destruction of any rectus abdominus muscle. However, a DIEP flap harvest damages the anterior rectus fascia in all cases, and intermittently transects or causes significant neuropraxia of the intercostal nerves, particularly if more than one perforator is required. In addition, the longer the vascular pedicle harvest, the longer the fascia incision, and the greater the chance of intercostal nerve damage. This can lead to increased pain, lower abdominal wall bulging and hernia development (1-4).The superficial inferior epigastric artery (SIEA) flap uses a medially located vein -the superficial epigastric artery -and, rarely, its associated venea to reliably perfuse the ipsilateral hemiabdominal wall skin and fat. The anterior abdominal wall fascia is left intact in all cases. This technique all but eliminates the possibility of an iatrogenic anterior abdominal wall hernia. Pain is also typically decreased because the muscle, fascia and nerves to the anterior abdominal wall are left intact. Despite the potential benefits, the use of this flap has been limited in breast reconstruction when compared with the deep inferior arterybased flaps. Cited reasons for this include: that typical perfusion only supports an ispilateral hemiabdomen (3,5-7); the SIEA vessels have been cut preoperatively in many cases due to previous pfannenstiel incisions; and the diameter of the artery is believed to be of insufficient size to reliably complete a successful microvascular anastomosis. The highest reported rate of use of the SIEA flap versus the DIEA-based flaps has been in the 30% range (3,5,8,9). Yet, the presence of the SIEA and venea, and the SIEV of sufficient calibre has been documented in anatomical studies to be available in nearly 75% of cases (10).Over the past 10 years, our use of the SIEA flap has progressed from a rare event to more than 35% of all abdominal wall-based autologous breast reconstructions performed at our institution. The change in harvest technique and the algorithm for selection are described below with video documentation of the technique. Lower abdominaL waLL-based autoLogous tissue harvest aLgorithmThe algorithm for deciding whether to use a SIEA flap is based on the following considerations. Fi...

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An anatomical study of the superficial inferior epigastric vessels in humans

Cited by 91 publications

References 9 publications

Double Venous System Drainage in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Double Venous System Drainage in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction

Variant Anatomy of Superficial Epigastric Vessels and their Significance in Breast Reconstructive Surgery After Mastectomy

Rethinking the superficial inferior epigastric artery flap in breast reconstruction: Video demonstration of a rapid, reliable harvest technique

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