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The epiploic flow‐through flap: preoperative evaluation of right gatroepiploic artery on multidetector computed tomography.
Author(s) -
Settembre Nicla,
Malikov Sergueï,
Bouziane Zakariyae,
Braun Marc
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.552.4
Subject(s) - medicine , laparotomy , coronal plane , radiology , arteritis , nuclear medicine , surgery
The gastroepiploic artery (GEA) and the greater omentum are nowadays commonly used in many reconstructive surgeries including cardiac, vascular and plastic surgery. There are cases in which the GEA is found to be unsuitable only after partial harvesting following an upper laparotomy, and an improved method of preoperative evaluation is required to eliminate the need for intraoperative small laparotomy Methods Multidetector computed tomography was performed for 30 consecutive patients admitted for lower limb ischemia in a routine preoperative evaluation of lower limb atherosclerotic arteritis. The origin of the GEA was checked on coronal and sagital slices, its pathway was identified on the three‐dimensional rendering. We assessed length and mean diameter of the distal and proximal right GEA, and the mean distances between the origins of GEA and the omental branches. Results 30 patients were included in our study. Routine pre operative MCDT during lower limb artherosclerotic arteritis workup enabled identification of GEA in all cases The mean internal diameter of the GEA at its origin was 3.28mm (±3.3). The mean internal diameter of the distal GEA was 1.26mm (±0.29). The mean length of GEA was 23,22cm (± 5,28). At least one omental descending branch was detected and in 63% (19 patients) at least two branches were visualised. Conclusion Routine preoperative MDCT imaging is an effective tool to assess precisely the different anatomical properties of the GEA. This exam could be useful for both diagnosis of lower limb arteritis and evaluation of the GEA suitability for flow‐through flap lower limb revascularisation.