CT Angiography in the Preoperative Evaluation as a Predictor of Surgical Time for DIEP

Abstract

Computed tomography angiography (CT-angiography) provides a clear view of the perforating vessels and their course, being essential in the preoperative evaluation of mastectomies. In the case of DIEP (deep lower epigastric artery), the prior identification of these vessels is of great importance for breast reconstruction, because in addition to being a predictor of surgical time, it helps in the correct approach of the arteries. Objective: To analyze CT angiography as a predictor of the surgical time for DIEP, when performed in the preoperative evaluation. Methods: A database from the Royal Perth Hospital in Australia was analyzed, with a total of 104 mastectomies performed during the period from January to December 2017. Among them, 19 were for breast reconstruction by DIEP. The patients had an average of 47 years, ranging from 31 to 69 years. Results: We obtained that when the average number of arteries in the CT angiography is less than four, there will be an average decrease of 34 minutes in the total time of surgery. However, if the number is greater than or equal to five arteries, there will be an average increase of 34 minutes, totaling an average of 452 and 551 total minutes of surgery, respectively. Conclusion: Angio-CT is an important predictor to predict the average time of surgery, one of the main factors related to complications when prolonged.