Angiogram Before Breast Reconstruction Surgery

asked 2 years ago by Jen G
Latest answer by David Greenspun, MD, MSc
Question viewed 479 times
Tags: breasts

Should I have an angiogram before breast reconstruction surgery?

11 answers to Angiogram Before Breast Reconstruction Surgery

Vascular evaluation before breast reconstruction

I wrote a paper on color flow duplex exams of TRAM flap perforators many years ago so I believe that sometimes a flap's vascular supply is best evaluated preop. An angiogram is an invasive study which has some risks and is usually not necessary. A CT angiogram is sometimes done now instead of the color flow duplex.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Angiogram Before Breast Reconstruction

An angiogram is not required in routine breast reconstruction using a pedicled flap (latissimus or TRAM) or using tissue expanders and breast implants. In cases where tissue is transferred microsurgically, the presence of recipient vessels (those into which the flap is attached) and the vascular anatomy of certain flaps is verified sometimes with angiograms. It is up to your Plastic surgeon to decide if he / she needs an angiogram to back up the technique he / she plans to use on you. Dr. P.... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Blood Vessel Mapping before Breast Reconstruction Surgery

Depending on what kind of breast reconstruction you are planning to have, an angiogram may be an excellent planning tool. Preoperative blood vessel mapping ahead of perforator flap microsurgical breast reconstruction helps to assure that your surgeon will select the very best available blood vessels for you surgery. Some surgeons use CT angiography (CTA) while others use MR angiography (MRA). I prefer to use MRA (only when a woman has a contraindication to MRA do I use CTA in my... more

David Greenspun, MD, MSc
New York Plastic Surgeon

www.davidgreenspunmd.com

Angiogram before reconstruction

Depending upon the type of reconstruction offered, you may need one. With DIEP flaps it is nice to get an MRAngiogram to delineate the anatomy and identify the perforators more easily.

Steven Wallach, MD
Manhattan Plastic Surgeon

Angiogram for breast reconstruction

A special CT angiogram can aid your plastic surgeon in autologous DIEP reconstruction. However, it is definitely not necessary. We perform at least one DIEP Free flap per week and to date, we have not ordered a CT angiogram preoperatively. We feel we can safely perform a DIEP flap without this added test (which is not without expense or risks). Having said that, there are newer less invasive modalities emerging that can aide plastic surgeons performing perforator... more

C. Bob Basu, MD
Houston Plastic Surgeon

www.basuplasticsurgery.com

Angiogram for breast reconstruction

The only use for an angiogram in breast reconstruction that I am of aware is a CT Angiogram to assist in preoperatively planning of a DIEP flap reconstruction. It is thought to assist the surgeon in picking the optimal perforator blood supply to the overlying abdominal soft tissue. With experience, your microsurgeon should feel comfortable selecting the appropriate perforators without this additional test. I do not think that an angiogram is necessary unless i am... more

Paul S. Gill, MD
Houston Plastic Surgeon

Angiogram before breast reconstruction surgery

If your reconstructive surgeon requests it than maybe he has a reason you are not relating to us, the expert posters! Please discuss with your surgeon. Regards from MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Traditional angiogram not traditionally performed before breast reconstruction

Hi, Breast reconstruction can refer to operations utilizing implants, pedicled flaps (where the blood supply to the tissue transferred in not disconnected), and microvascular tissue transfer (where the flap blood supply is disconnected and then re-connected to another blood vessel). Although not always standard practice, studies evaluating the blood supply to the flap, or the availability of recipient blood vessels for microvascular tissue transfer, do have a role in some patients... more

Sam Jejurikar, MD
Dallas Plastic Surgeon

Breast reconstruction does not routinely require an angiogram

An angiogram is an invasive test used to determine vascular anatomy. In terms of breast reconstruction, an angiogram may prove useful if your plastic surgeon is planning a free flap (tissue transferred from a separate area of the body) to reconstruct your breast. This would require attaching vessels from the free flap to vessels at the recipient site using microsurgery. There are several alternative options for breast reconstruction however, that do not require microsurgery or the need... more

David A. Robinson, MD
Munster Plastic Surgeon

Angiogram to assess flap vascularity in Breast reconstruction

There are many other non-invasive options that are currently available to evaluate flap viability. Generally these are not routinely used unless there is some question about the vascularity such as previous surgery. However, they do provide valuable information albeit at a high cost. In some instances, they are useful for perforator flaps.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Angiogram depends on kind of breast reconstruction

If your plastic surgeon plans to do DIEP flap for the breast reconstruction, a CT angiogram can help to visulize the perforaters. The need for angiogram is rare unless there is a concern about the anatomy of the blood vessels.