Anastomosis of the Superficial Inferior Epigastric Vein to the Internal Mammary Vein to Augment Deep Inferior Artery Perforator Flaps

Aparna Vijayasekaran; Anita T Mohan; Lin Zhu; Basel Sharaf; Michel Saint-Cyr

doi:10.1016/j.cps.2016.12.006

Anastomosis of the Superficial Inferior Epigastric Vein to the Internal Mammary Vein to Augment Deep Inferior Artery Perforator Flaps

Clin Plast Surg. 2017 Apr;44(2):361-369. doi: 10.1016/j.cps.2016.12.006. Epub 2017 Feb 9.

Authors

Aparna Vijayasekaran¹, Anita T Mohan², Lin Zhu³, Basel Sharaf², Michel Saint-Cyr⁴

Affiliations

¹ Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: [email protected].
² Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
³ Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
⁴ Division of Plastic Surgery, Baylor Scott & White Health, Scott & White Memorial Hospital, MS-01-E443, 2401 South 31st Street, Temple, TX 76508, USA.

PMID: 28340668
DOI: 10.1016/j.cps.2016.12.006

Abstract

Use of the retrograde limb of the internal mammary vein has been described previously as a lifeboat for venous congestion but not prophylactically. Maximizing the length of the deep inferior artery perforator (DIEP) flap pedicle, identifying and dissecting the superficial inferior epigastric vein proximally in every patient, and taking advantage of the retrograde internal mammary vein are all technical details that facilitate the additional venous anastomosis and flap inset. Performing a second venous anastomosis routinely using the superficial inferior epigastric vein to the retrograde internal mammary vein helps with flap inset.

Keywords: Deep inferior artery perforator flap; Venous augmentation; Venous congestion.

Publication types

Review

MeSH terms

Anastomosis, Surgical*
Arteries / surgery*
Female
Humans
Mammaplasty*
Perforator Flap / blood supply*
Veins / surgery*