Correlation between vessel diameters of superficial and deep inferior epigastric systems: Doppler ultrasound assessment

Abstract

Background: The deep inferior epigastric artery perforator (DIEAP) flap is a technically demanding procedure and the dissection is directly influenced by the size of the perforator vessels. There is a common belief that the size of the superficial inferior epigastric vein (SIEV) is inversely proportional to the perforators from the deep inferior epigastric system. To investigate the validity of this hypothesis, we evaluated and compared the diameters of the SIEV and deep inferior epigastric perforator vessels (DIEP-A and DIEP-V).

Methods: Between 2004 and 2006, 50 patients scheduled for breast reconstruction with autologous tissue were evaluated with colour Doppler ultrasound to determine the diameters of SIEV and DIE perforator vessels. The correlation between SIEV and ipsilateral DIEP-V, the correlation between DIE perforator vessels on each side and the impact of body mass index were assessed. Results were analysed statistically to compare the diameter of the SIEV with the largest perforator on the same side and the largest perforators on the contralateral side. Additionally, partial correlation coefficients were calculated to assess if there is an inverse correlation between SIEV and DIE perforators.

Results: Diameters of SIEV ranged from 0.50 to 4.06 mm. DIEP-A ranged from 1.00 to 3.49 mm, while DIEP-V ranged from 0.50 to 4.32 mm. There was a slightly inverse correlation between the size of SIEV and DIEP-V, but this was not statistically significant. However, the correlation between SIEVs on both sides was statistically significant. There was also a strong correlation between the size of DIEP-A and DIEP-V on the same side as well as the size of those on the contralateral side. However, the largest artery and vein matched only in 50% of perforator bundles on the right and 62% on the left side. In addition, the vessel diameters increased as the body mass index increased; however, this finding was significant only for perforator veins.

Conclusion: The inverse correlation between the size of SIEV and DIEP-V was not significant. If SIEV and DIE perforator vessels are large on one side, they are also large on the other side. In addition, the larger the artery, the larger is the vein on the same perforator. However, the largest arteries and veins are not necessarily on the same perforator bundle.