Two-detector Computed Tomography Map of the Inferior Epigastric Vessels for Percutaneous Transabdominal Intervention Procedures

Yıl 2014, , 72 - 76, 07.08.2014

Hakan Gençhellaç Memduh Dursun Osman Temizöz Osman Temizöz Bekir Çağlı Mustafa K. Demir

https://doi.org/10.5152/balkanmedj.2014.13002

Öz

Background: It is crucial to know anatomic variations and the exact course of an inferior epigastric artery (IEA) to prevent any complications during percutaneous abdominal interventions. Aims: The aim of this study was to map the inferior epigastric vessels using reconstructed two-detector computed tomography images and measure the distance from the inferior epigastric artery (IEA) to the midline to determine a safe route for percutaneous abdominal interventions. Study Design: Retrospective comparative study. Methods: Coronal reconstructed two-detector computed tomography images of 200 patients were evaluated to measure the distances between the IEA and midline at three levels (origin, middle, and distal). Vein and artery arrangements were documented. Results: The most frequently encountered arrangement (41.5%) was a single vein and artery on both sides. Mean distances on the right and left sides were 4.01 and 4.47 cm at the umbilical level, 3.81 and 4.26 cm at the midlevel, and 5.62 and 5.51 cm at the origin level. On both sides, measurement differences between the three levels were highly significant (p<0.05). In addition, a total of 56 IEA bifurcations were depicted in all 200 patients. Thirteen of the 56 bifurcations occurred only on the right side, 11 only on the left side, and 32 on both sides. Conclusion: It is important to be attentive to the IEA's course, at different midline levels, when attempting percutaneous interventions via an abdominal approach.

Anahtar Kelimeler

Abdominal approach, inferior epigastric, midline, percutaneous interventions, two-detector computed tomography, vessels

Two-detector Computed Tomography Map of the Inferior Epigastric Vessels for Percutaneous Transabdominal Intervention Procedures

Öz

Kaynakça

• Saber AA, Meslemani AM, Davis R, Pimentel R. Safety zones for anterior abdominal wall entry during laparoscopy: a CT scan mapping of epigastric vessels. Ann Surg 2004;239:182-5. [CrossRef]
• Sriprasad S, Yu DF, Muir GH, Poulsen J, Sidhu PS. Positional anatomy of vessels that may be damaged at laparoscopy: new access criteria based on CT and ultrasonography to avoid vascular injury. J Endourol 2006;20:498-503. [CrossRef]
• Alonso-Burgos A, Garcia-Tutor E, Bastarrika G, Cano D, Martinez- Cuesta A, Pina LJ. Preoperative planning of deep inferior epigastric artery perforator flap reconstruction with multislice-CT angiography: imaging findings and initial experience. J Plast Reconstr Aesthet Surg 2006;59:585-93. [CrossRef]
• Masia J, Clavero JA, Larranaga JR, Alomar X, Pons G, Serret P. Multidetector-row computed tomography in the planning of abdominal perforator flaps. J Plast Reconstr Aesthet Surg 2006;59:594-9. [CrossRef]
• Piorkowski JR, DeRosier LC, Nickerson P, Fix RJ. Preoperative computed tomography angiogram to predict patients with favorable anatomy for superficial inferio epigastric artery flap breast reconstruction. Ann Plast Surg 2011;66:534-6. [CrossRef]
• Karunanithy N, Rose V, Lim AK, Mitchell A. CT angiography of inferior epigastric and gluteal perforating arteries before free breast reconstruction. Radiographics 2011;31:1307-19. [CrossRef]
• Zaki H, Penketh R, Newton J. Gynaecological laparoscopy audit: birmingham experience. Gynecol Endocrinol 1995;4:251-7.
• Aharoni A, Condea A, Leibovitz Z, et al. A comparative study of Foley catheter and suturing to control trocar-induced abdominal wall haemorrhage. Gynecol Endocrinol 1997;6:31-2.
• Vasquez JM. Vascular complications of laparoscopic surgery. J Am Assoc Gynecol Laparosc 1994;1:163-7. [CrossRef]
• Spitzer M, Golden P, Rehwaldt L, Benjamin F. Repair of laparoscopic injury to abdominal wall arteries complicated by cutaneous necrosis. J Am Assoc Gynecol Laparosc 1996;3:449-52. [CrossRef]
• Hurd WW, Pearl ML, DeLancey JO, Quint EH, Garnett B, Bude RO. Laparoscopic injury of abdominal wall blood vessels: a report of three cases. Obstet Gynecol 1993;82:673-6. [CrossRef]
• Lin P. Complications of laparoscopy: strategies for prevention and cure. Obstet Gynecol Clin North Am 1999;26:23-38. [CrossRef]
• Lavery S, Porter S, Trew G, Margara R, Jackson J. Use of inferior epigastric artery embolization to arrest bleeding at operative laparoscopy. Fertil Steril 2006;86:719.e13-4.
• Takase K, Kazama T, Abe K, Chiba Y, Saito H, Takahashi S. Pseudoaneurysm of the inferior epigastric artery successfully treated by ultrasound-guided compression. Cardiovasc Intervent Radiol 2004;27:520-2. [CrossRef]
• Pinero A, Reus M, Agea B, Capel A, Riquelme J, Parrilla P. Conservative management of an arteriovenous fistula of the inferior epigastric artery. Br J Radiol 2003;76:135-6. [CrossRef]
• Jayawardene SA, Goldsmith DJ. Rectus sheath haematomata in patients with renal disease. Nephrol Dial Transplant 2002;17:1832-5. [CrossRef]
• Ries AM, Nycum LR, Reed ME. Myonecrosis of the rectus muscle after a Cherney incision. Gynecol Oncol 1998;68:66-8. [CrossRef]
• Patterson JA, Tilkian AG. Retroperitoneal hemorrhage from inferior epigastric artery. Catheter Cardiovasc Interv 2007;69:926. [CrossRef]
• Mulpuru SK, Mori NA, Levey RL, Leonardo R. Life-threatening hematoma associated with paracentesis: a case report. Blood Coagul Fibrinolysis 2006;17:491-3. [CrossRef]
• Todd AW. Inadvertent puncture of the inferior epigastric artery during needle biopsy with fatal outcome. Clin Radiol 2001;56:989-90. [CrossRef]
• Krupski WC, Sumchai A, Effeney DJ, Ehrenfeld WK. The importance of abdominal wall collateral blood vessels. Planning incisions and obtaining arteriography. Arch Surg 1984;119:854-7. [CrossRef]
• Sistrom CL, Reiheld CT, Elliot H. Reversal of flow in the inferior epigastric arteries, Doppler ultrasonographic findings and significance. J Ultrasound Med 1995; 14:183-91.
• Verbist J. Pseudoaneurysm of the inferior epigastric artery. Acta Chir Belg 1997;97:196-8.
• Pun TC, Chau MT, Lam C, Tang G, Leong L. Sonographic localization of abdominal vessels in Chinese women: its role in laparoscopic surgery. Ultrasound Obstet Gynecol 1998;11:59-61. [CrossRef]
• Nezhat CH, Nezhat F, Brill AI, Nezhat C. Normal variations of abdominal and pelvic anatomy evaluated at laparoscopy. Obstet Gynecol 1999;94:238-42. [CrossRef]
• El-Mrakby HH, Milner RH. The vascular anatomy of the lower anterior abdominal wall: a microdissection study on the deep inferior epigastric vessels and the perforator branches. Plast Reconstr Surg 2002;109: 539-43. [CrossRef]
• Shafighi M, Schwabegger AH, Michelle E, Gurunluoglu R. A cadaver study: the course of the inferior epigastric vessels. Plast Reconstr Surg 2003;112:341-3. [CrossRef]