J Reconstr Microsurg 2009; 25(5): 289-293
DOI: 10.1055/s-0029-1202553
© Thieme Medical Publishers

The Absent Inferior Epigastric Artery: A Unique Anomaly and Implications for Deep Inferior Epigastric Artery Perforator Flaps

Warren M. Rozen1 , Nicholas D. Houseman1 , Mark W. Ashton1
  • 1Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Department of Anatomy and Cell Biology, The University of Melbourne, Victoria, Australia
Further Information

Publication History

Publication Date:
04 March 2009 (online)

ABSTRACT

The abdominal wall is particularly advantageous as a donor site due to the reliability of its vascular supply. Although the cutaneous perforators of the deep inferior epigastric artery (DIEA) and the superficial inferior epigastric artery (SIEA) may show significant individual variability, the DIEA itself has been shown to be ever-present as a vascular pedicle and to be highly dependable. The increasing use of preoperative computed tomographic angiography (CTA) has led to increasing reports of anatomic variability. With the use of preoperative CTA, we describe a unique case of a completely absent DIEA in patient who had not previously undergone any open abdominal surgery. The absence of the DIEA had led to vascular changes throughout the abdominal wall, including dilatation of both SIEAs and the ipsilateral deep superior epigastric artery. Preoperative CTA in this setting helped us identify this anomaly and aided surgical planning. The incidence of this anomaly was subsequently reviewed in 150 consecutive CTA scans performed at our institution.

REFERENCES

Dr. Warren M Rozen

Jack Brockhoff Reconstructive Plastic Surgery Research Unit, Room E533, Department of Anatomy and Cell Biology, The University of Melbourne, Parkville

Victoria 3050, Australia

Email: warrenrozen@hotmail.com