Anatomical Study for Vascular Distribution of the Perforator of Deep Inferior Epigastric Artery in Koreans

ABSTRACT

PURPOSE: The pedicle of transverse rectus abdominis myocutaneous(TRAM) flap and deep inferior epigastric arterial perforator flap is deep inferior epigastic artery (DIEA) and accurate anatomic knowledge about perforator of DIEA is very important for the elevation of these flap. The authors investigated a detailed vascular network of perforator of DIEA in Koreans. METHODS: 24 fresh cadavers were studied. Among them, 15 were examined based on the plain X-ray examination for the distribution and location of perforator of DIEA. And 9 fresh cadavers were examined based on the 3-dimensional computed tomography(CT) study for the distance between ending point of perforator of DIEA and mother artery, the distance between most medial mother artery and midline, the distance between most lateral mother artery and midline, and the running type of perforators of DIEA. RESULTS: Based on the plain X-ray examination, suitable(external diameter> or =0.5mm) perforators of DIEA are located between the level of umbilicus and 8cm below it. Based on the 3D-CT study, average distance between the ending point of perforator of DIEA and the mother artery is 30.26mm on the left, 28.62mm on the right, respectively. The average distance between most medial mother artery and midline is 17.13mm on the left, 15.76mm on the right, respectively. The average distance between most lateral mother artery and midline is 56.31mm on the left, 50.90mm on the right, respectively. The main running course of suitable perforators of DIEA is type a, which is a direct musculocutaneous perforator vessel from main vascular axis passing outward to join the subdermal plexus, directly. CONCLUSION:3-dimensional computed tomography study as well as plain X-ray examination provided more accurate and detail informations about perforators of DIEA in Koreans. These informations will help us understand the detailed vascular anatomy and operation with ease and safe in the lower abdomen of Koreans.