I have had a c-section and a few months later my tubes tied in 1994 and a total hysterectomy in 1995 and am now having a mastectomy and possibly a Diep Flap reconstruction in a few weeks. My plastic surgeon wants a CTA before and I went to have it done but I have very deep and small veins and they could not find one big enough for the contrast. Since I have already had radiation treatments I have been recommended that implants aren't a good idea. What other options do I have if I can't have a CTA?
Answer: CTA helps with operative planning, but is not a 100% requirement for the surgery Hi connerdmc,
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Answer: CTA helps with operative planning, but is not a 100% requirement for the surgery Hi connerdmc,
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Answer: Imaging is very helpful before DIEP flap Preoperative MR Angiogram or CT Angiogram helps the surgeon determine1. that the blood vessels are patent (surgery can be done)2. location of the blood vessels (most efficient way to get surgery done)
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Answer: Imaging is very helpful before DIEP flap Preoperative MR Angiogram or CT Angiogram helps the surgeon determine1. that the blood vessels are patent (surgery can be done)2. location of the blood vessels (most efficient way to get surgery done)
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November 20, 2016
Answer: CTA for DIEP There are many DIEP surgeons who do not need to get a CTA beforehand as it is the dissection during the actual surgery that will determine whether you can have the DIEP or not. This includes the vessels in the abdomen and the vessels in the chest. The CTA is only a roadmap and that map can look very different when you are looking at the actual vessels. I have done this procedure without the CTA and it will depend on the comfort level of your surgeon to do so. You have had abdominal surgeries and this may be a reason why the CTA was ordered to make sure that the DIEP vessels have not been damaged. The DIEP is the gold standard in breast reconstruction for a patient who has had radiation as implants alone have a high complication rate. Other options are the TRAM or Latissimus flaps but both procedures sacrifice muscles. When I discuss options with my patients I will tell them if I find during surgery that the DIEP cannot be performed then would they want to have a TRAM which means sacrificing muscle and can cause you problems in function. This is something you need to discuss with your PS. Best wishes.
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November 20, 2016
Answer: CTA for DIEP There are many DIEP surgeons who do not need to get a CTA beforehand as it is the dissection during the actual surgery that will determine whether you can have the DIEP or not. This includes the vessels in the abdomen and the vessels in the chest. The CTA is only a roadmap and that map can look very different when you are looking at the actual vessels. I have done this procedure without the CTA and it will depend on the comfort level of your surgeon to do so. You have had abdominal surgeries and this may be a reason why the CTA was ordered to make sure that the DIEP vessels have not been damaged. The DIEP is the gold standard in breast reconstruction for a patient who has had radiation as implants alone have a high complication rate. Other options are the TRAM or Latissimus flaps but both procedures sacrifice muscles. When I discuss options with my patients I will tell them if I find during surgery that the DIEP cannot be performed then would they want to have a TRAM which means sacrificing muscle and can cause you problems in function. This is something you need to discuss with your PS. Best wishes.
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November 21, 2016
Answer: CTA for DIEP Flaps Thanks for your question.
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November 21, 2016
Answer: CTA for DIEP Flaps Thanks for your question.
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November 20, 2016
Answer: Ct or MR Your surgeon wants the study to map out the vessels in you flap so that he can determine what vessels would be appropriate. Best of luck.
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November 20, 2016
Answer: Ct or MR Your surgeon wants the study to map out the vessels in you flap so that he can determine what vessels would be appropriate. Best of luck.
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