The thoracoacromial artery as the lifeboat in recipient artery deficiency in complex chest wall defect reconstruction

Yavari, Ali; Molae, Hojjat; Ghahremani, Arjang; Etemad, Omid; Amini, Hesam; Shahab, Rafieian

doi:10.1016/j.ijscr.2023.108057

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…There is also risk of radiation-induced vasculopathy in this patient who has had radiotherapy. 9,10 Several steps can be taken as part of the planning prior to surgery which includes preoperative CT angiogram or doppler studies to identify patency of the thoracodorsal vessels. Animal studies have also shown that the use of atorvastatin prevented vascular damage in patients undergoing radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

Chest wall reconstruction in recurrent breast carcinoma – a case report

Choy,

Mohd Zainal,

Mat Zain

2024

Pol. Ann. Med.

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IntroductionComplex chest wall reconstruction after an oncological resection requires a multidisciplinary approach with the aim of curative resection.AimThe complexity of such reconstruction is challenged by prior reconstructions that limit the options for free tissue transfer and recipient vessels for microsurgical anastomoses.Case studyWe present a case of an immunocompromised patient with prior breast reconstruction for left breast carcinoma with a pedicled lattisimus dorsi flap who presents with a recurrence to the latissimus dorsi flap requiring a more extensive oncological resection.Results and discussionThis resulted in a large chest wall defect that is reconstructed with plating and an anterolateral thigh fasciocutaneous free flap for soft tissue coverage.ConclusionsThe radical resection allows for excellent overall survival and better quality of life.

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Section: Discussionmentioning

confidence: 99%

Chest wall reconstruction in recurrent breast carcinoma – a case report

Choy,

Mohd Zainal,

Mat Zain

2024

Pol. Ann. Med.

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Microsurgical reconstruction using thoracoacromial vessels as recipients for complicated chest wall defects

Kim,

Lee

2024

Microsurgery

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BackgroundFree tissue transfer is often required for the reconstruction of complex and deep anterior chest wall wounds, for which the identification of suitable recipient vessels is crucial. Although the internal mammary arteries (IMAs) are a representative option, identifying secondary options when these vessels are compromised remains a challenge. This report evaluated the efficacy of using the thoracoacromial vessels (TAVs) as recipients for chest wall reconstruction by reviewing our experience.MethodsWe conducted a retrospective review of patients undergoing free‐flap‐based chest wall reconstruction using TAVs as recipient vessels from February 2020 to March 2023. Patient demographics and surgery‐related characteristics data were collected. The primary outcome of interest was the occurrence of flap perfusion‐related complications.ResultsIn total, 12 cases utilized TAVs as recipients, primarily for defects following sternotomy, where bilateral IMA was unavailable due to prior surgery. The TAVs with reliable perfusion were consistently identified beneath the pectoralis major muscle. The anterolateral thigh flap was predominantly employed, with musculocutaneous or chimeric flaps introduced for bony defects. The mean pedicle length of the harvested flap was 7.2 cm (range, 3–13), and in cases with a vascular gap, the pedicle was extended using an arteriovenous interposition graft. This resulted in a mean pedicle length needed to reach recipient vessels of 9.9 cm (range, 6.5–19). All flaps survived, with only one experiencing partial necrosis.ConclusionsThe TAV could be considered as an attractive alternative recipient vessel in microsurgical reconstruction of complicated chest wall defects when the use of IMA is not feasible.

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The thoracoacromial artery as the lifeboat in recipient artery deficiency in complex chest wall defect reconstruction

Cited by 2 publications

References 11 publications

Chest wall reconstruction in recurrent breast carcinoma – a case report

Chest wall reconstruction in recurrent breast carcinoma – a case report

Microsurgical reconstruction using thoracoacromial vessels as recipients for complicated chest wall defects

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