Color Doppler ultrasound versus CT angiography for DIEP flap
planning: A randomized controlled trial

J 2023

Color Doppler ultrasound versus CT angiography for DIEP flap planning: A randomized controlled trial

BAJUS, Adam, Libor STREIT, Tomas KUBEK, Adam NOVÁK, Jiří VANÍČEK et. al.

Základní údaje

Originální název

Color Doppler ultrasound versus CT angiography for DIEP flap planning: A randomized controlled trial

Autoři

BAJUS, Adam (203 Česká republika, domácí), Libor STREIT (203 Česká republika, garant, domácí), Tomas KUBEK (203 Česká republika), Adam NOVÁK (203 Česká republika, domácí), Jiří VANÍČEK (203 Česká republika), Ondřej ŠEDIVÝ (203 Česká republika, domácí), Andrej BERKEŠ (703 Slovensko, domácí), Kadir Can BAYEZID (792 Turecko, domácí), Lukáš KUNOVSKÝ (703 Slovensko, domácí) a Luboš DRAŽAN (203 Česká republika, domácí)

Vydání

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, OXFORD, ELSEVIER SCI LTD, 2023, 1748-6815

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.700 v roce 2022

Kód RIV

RIV/00216224:14110/23:00132937

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.bjps.2023.07.042

UT WoS

001080047100001

Klíčová slova česky

IEP flap perforator mapping; Localization of perforators; Color Doppler ultrasound; Computed tomographic angiography; Breast reconstruction; Perforator flaps

Klíčová slova anglicky

DIEP flap perforator mapping; Localization of perforators; Color Doppler ultrasound; Computed tomographic angiography; Breast reconstruction; Perforator flaps

Štítky

14110119, 14110128, Excelence Science, FNUSA, LF MU Brno, MOÚ, RIV, rivok, user, článek v časopise

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 14. 2. 2024 08:52, Mgr. Tereza Miškechová

Anotace

V originále

Background: Identifying relevant perforators is crucial in planning a deep inferior epigastric perforator (DIEP) flap. Color Doppler ultrasonography (CDU) has gained popularity for localizing perforators; however, current evidence on its efficiency is still inconclusive. This study aimed to compare the efficiency of CDU with that of computed tomography angiography (CTA) in localizing and selecting the relevant perforators.Methods: In this randomized controlled trial, 60 patients undergoing DIEP flap breast reconstruction (uni- or bilateral) were randomly assigned to the CDU group (i.e., CDU was performed to map and select the relevant perforators preoperatively) or the CTA+CDU group (i.e., mapping was based on CTA and supplemented by CDU). CDU was performed by the same surgeon with a well-defined sonography experience from our previous study. The reference XY coordinates of the dissected perforators were measured intraoperatively, and deviations from preoperatively deducted coordinates were calculated (Delta CDU or Delta CTA+CDU). The flaps were categorized according to the number of dissected perforators, and adherence to the pre-operative strategy was evaluated.Results: Overall, 22 patients (30 flaps) in the CTA+CDU group and 27 (39 flaps) patients in the CDU group were evaluated. The average Delta CDU (0.6 cm) was significantly lower than the average Delta CTA+CDU (1.0 cm) (p < 0.001). Adherence to the mapping-based dissection strategy was higher in the CDU group; however, the difference was insignificant (p = 0.092).Conclusion: CDU is not inferior to CTA + CDU in localizing and selecting relevant DIEA perforators. Therefore, CDU mapping is a possible complementary or substitute modality for CTA mapping.(c) 2023 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.

Návaznosti

MUNI/A/1360/2022, interní kód MU

Název: Evaluace inovativních postupů plastické a rekonstrukční chirurgie III

Investor: Masarykova univerzita, Evaluace inovativních postupů plastické a rekonstrukční chirurgie III

MUNI/A/1668/2020, interní kód MU

Název: Evaluace inovativních postupů plastické a rekonstrukční chirurgie (Akronym: KPECH SV 2021)

Investor: Masarykova univerzita, Evaluace inovativních postupů plastické a rekonstrukční chirurgie

90249, velká výzkumná infrastruktura

Název: CZECRIN IV

Citovat

BAJUS, Adam, Libor STREIT, Tomas KUBEK, Adam NOVÁK, Jiří VANÍČEK, Ondřej ŠEDIVÝ, Andrej BERKEŠ, Kadir Can BAYEZID, Lukáš KUNOVSKÝ a Luboš DRAŽAN. Color Doppler ultrasound versus CT angiography for DIEP flap planning: A randomized controlled trial. JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY. OXFORD: ELSEVIER SCI LTD, 2023, roč. 86, November 2023, s. 48-57. ISSN 1748-6815. Dostupné z: https://dx.doi.org/10.1016/j.bjps.2023.07.042.

@article{2359444,
   author = {Bajus, Adam and Streit, Libor and Kubek, Tomas and Novák, Adam and Vaníček, Jiří and Šedivý, Ondřej and Berkeš, Andrej and Bayezid, Kadir Can and Kunovský, Lukáš and Dražan, Luboš},
   article_location = {OXFORD},
   article_number = {November 2023},
   doi = {http://dx.doi.org/10.1016/j.bjps.2023.07.042},
   keywords = {DIEP flap perforator mapping; Localization of perforators; Color Doppler ultrasound; Computed tomographic angiography; Breast reconstruction; Perforator flaps},
   language = {eng},
   issn = {1748-6815},
   journal = {JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY},
   title = {Color Doppler ultrasound versus CT angiography for DIEP flap planning: A randomized controlled trial},
   url = {https://www.webofscience.com/wos/woscc/full-record/WOS:001080047100001},
   volume = {86},
   year = {2023}
}

TY  - JOUR
ID  - 2359444
AU  - Bajus, Adam - Streit, Libor - Kubek, Tomas - Novák, Adam - Vaníček, Jiří - Šedivý, Ondřej - Berkeš, Andrej - Bayezid, Kadir Can - Kunovský, Lukáš - Dražan, Luboš
PY  - 2023
TI  - Color Doppler ultrasound versus CT angiography for DIEP flap planning: A randomized controlled trial
JF  - JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
VL  - 86
IS  - November 2023
SP  - 48-57
EP  - 48-57
PB  - ELSEVIER SCI LTD
SN  - 17486815
KW  - DIEP flap perforator mapping
KW  - Localization of perforators
KW  - Color Doppler ultrasound
KW  - Computed tomographic angiography
KW  - Breast reconstruction
KW  - Perforator flaps
UR  - https://www.webofscience.com/wos/woscc/full-record/WOS:001080047100001
N2  - Background: Identifying relevant perforators is crucial in planning a deep inferior epigastric perforator (DIEP) flap. Color Doppler ultrasonography (CDU) has gained popularity for localizing perforators; however, current evidence on its efficiency is still inconclusive. This study aimed to compare the efficiency of CDU with that of computed tomography angiography (CTA) in localizing and selecting the relevant perforators.Methods: In this randomized controlled trial, 60 patients undergoing DIEP flap breast reconstruction (uni- or bilateral) were randomly assigned to the CDU group (i.e., CDU was performed to map and select the relevant perforators preoperatively) or the CTA+CDU group (i.e., mapping was based on CTA and supplemented by CDU). CDU was performed by the same surgeon with a well-defined sonography experience from our previous study. The reference XY coordinates of the dissected perforators were measured intraoperatively, and deviations from preoperatively deducted coordinates were calculated (Delta CDU or Delta CTA+CDU). The flaps were categorized according to the number of dissected perforators, and adherence to the pre-operative strategy was evaluated.Results: Overall, 22 patients (30 flaps) in the CTA+CDU group and 27 (39 flaps) patients in the CDU group were evaluated. The average Delta CDU (0.6 cm) was significantly lower than the average Delta CTA+CDU (1.0 cm) (p < 0.001). Adherence to the mapping-based dissection strategy was higher in the CDU group; however, the difference was insignificant (p = 0.092).Conclusion: CDU is not inferior to CTA + CDU in localizing and selecting relevant DIEA perforators. Therefore, CDU mapping is a possible complementary or substitute modality for CTA mapping.(c) 2023 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
ER  -

BAJUS, Adam, Libor STREIT, Tomas KUBEK, Adam NOVÁK, Jiří VANÍČEK, Ondřej ŠEDIVÝ, Andrej BERKEŠ, Kadir Can BAYEZID, Lukáš KUNOVSKÝ a Luboš DRAŽAN. Color Doppler ultrasound versus CT angiography for DIEP flap planning: A randomized controlled trial. \textit{JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY}. OXFORD: ELSEVIER SCI LTD, 2023, roč.~86, November 2023, s.~48-57. ISSN~1748-6815. Dostupné z: https://dx.doi.org/10.1016/j.bjps.2023.07.042.

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