Body mass index and Abdominal wall thickness correlate with perforator caliber in free abdominal tissue transfer for Breast Reconstruction

Abstract Introduction The aim of the study was to investigate the relationship between the BMI and abdominal wall thickness (AWT) as opposed to diameter of the dominant deep inferior epigastric artery perforator (DIEP) as well as DIEA branching pattern in the preoperatively performed Computed tomography angiography (CTA). Patients and Methods We conducted a retrospective study including all patients undergoing DIEP flap breast reconstruction with available CTAs from November 2013 to April 2018 in our department. The caliber-strongest DIEP was detected after passage of the rectus fascia as well as the superficial epigastric artery (SIEA) and correlated with the AWT 5cm above and below the umbilicus, lateral at the level of the umbilicus and at the level of the anterior superior iliac spine (ASIS) as well as the BMI. Results 77 patients met the inclusion criteria (Age: 47.3 ± 8.9 years). We could show a significant relationship (p Conclusion We demonstrated a correlation of the diameter of the dominant DIEP with both BMI and the AWT. Focusing on the diameter, in patients with a high AWT at the level of the ASIS the SIEA, if present, may represent an alternative therapeutic option.