Surgical planning and choice of perforator vessel in delayed deep inferior epigastric artery perforator (DIEAP) flap breast reconstruction

Melnikov D.V.; Abdeeva E.I.; Ivanov S.I.; Gombolevskiy V.A.

doi:https://doi.org/10.17116/plast.hirurgia20250315

Melnikov D.V.

Sechenov First Moscow State Medical University (Sechenov University);
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-7960-0951

Abdeeva E.I.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-0283-5370

Ivanov S.I.

Sechenov First Moscow State Medical University (Sechenov University);
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-8365-360X

Gombolevskiy V.A.

Sechenov First Moscow State Medical University (Sechenov University);
Artificial Intelligence Research Institute

ORCID: 0000-0003-1816-1315

Surgical planning and choice of perforator vessel in delayed deep inferior epigastric artery perforator (DIEAP) flap breast reconstruction

Authors:

Melnikov D.V., Abdeeva E.I., Ivanov S.I., Gombolevskiy V.A.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2025;(3): 5‑11

DOI: 10.17116/plast.hirurgia20250315

Read: 334 times

To cite this article:

Melnikov DV, Abdeeva EI, Ivanov SI, Gombolevskiy VA. Surgical planning and choice of perforator vessel in delayed deep inferior epigastric artery perforator (DIEAP) flap breast reconstruction. Plastic Surgery and Aesthetic Medicine. 2025;(3):5‑11. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia20250315

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)

Использование инфографики авторами научных работ

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OBJECTIVE

To determine an optimal method of the surgery planning and the perforator vessel selection in delayed deep inferior epigastric artery perforator (DIEAP) flap breast reconstruction (BR).

MATERIAL AND METHODS

A total of 119 female patients with a mean age of 46.3 (range 27—59) years and a mean body mass index of 28.57 (range 21.7—36.9) kg/m² who underwent delayed unilateral DIEAP flap BR were enrolled in this study. Patients were divided into two groups: the first included 72 women who underwent preoperative planning using non-contrast magnetic resonance angiography (MRA), the control group included 47 patients who underwent computed tomography angiography (CTA). We also analyzed the correlation between the row of the perforators and perfusion-related complications development in the flap. Statistical analysis was performed using the program StatTech v. 4.7.2 (StatTech LLC, Russia).

RESULTS

The overall operation time averaged 337.0 min in MRA group and 348.82 min in CTA group, particularly the time of the pedicle cut was 36.5 min in MRA group versus 45.5 min in CTA group (p<0.001). We found a statistically significant correlation between flap harvesting on medial row perforators and the risk of marginal flap necrosis and fat necrosis development.

CONCLUSIONS

Contrast-free MRA combines the advantages such as no ionizing radiation exposure, requires no potentially harmful contrast agent, and at the same time is high efficiency in relation to navigation on the pedicle cut stage.

Keywords:

breast reconstruction

DIEAP flap

preoperative planning

perforator flaps

computed tomography angiography (CTA)

magnetic resonance angiography (MRA)

Authors:

Melnikov D.V.

Sechenov First Moscow State Medical University (Sechenov University);
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-7960-0951

Abdeeva E.I.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-0283-5370

Ivanov S.I.

Sechenov First Moscow State Medical University (Sechenov University);
Institute of Plastic Surgery and Cosmetology

ORCID: 0000-0002-8365-360X

Gombolevskiy V.A.

Sechenov First Moscow State Medical University (Sechenov University);
Artificial Intelligence Research Institute

ORCID: 0000-0003-1816-1315

Received:

20.02.2025

Accepted:

15.03.2025

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References:

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