Journal of the Korean Microsurgical Society  2011;20(1):14-17

The Anatomical Variations of DIEA (Deep Inferior Epigastric Artery) in Microsurgical Breast Reconstruction: Clinical Report.

Seo Yoon JANG 1 ; Deok Woo KIM ; Eun Sang DHONG ; Eul Sik YOON ; Woo Sang RYU ; Gil Soo SON

Affiliations

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Keywords

Deep inferior epigastric artery; Anatomical variation; Microsurgical breast reconstruction

Country

Republic of Korea

Language

Korean

Abstract

Autologous breast reconstruction after mastectomy in breast cancer patient is now increasing. The deep inferior epigastric artery (DIEA) free flap is well known as an ideal donor site for the microsurgical breast reconstruction. The branching pattern of the DIEA was well described in the literature. In that study, DIEA has three branching patterns near the arcuate line. We describe a case in which branching variation of the DIEA before entering the posterior surface of the rectus abdominis muscle. In three cases, DIEA originated from the external iliac artery ascended as a double trunk at 1cm, 2cm, and 4cm above the originating point, respectively. In one case, DIEA ascended as a single trunk along the linea alba toward to the umbilicus until it supply overlying subcutaneous tissue. Preoperative 3D computed tomographic angiography to identify the anomaly is recommended and meticulous dissection to the originating point of DIEA is needed.