Use of the Cephalic Vein in DIEP Breast Reconstruction Does Not Increase Risk of Lymphedema of the Ipsilateral Arm

Flap failure is a rare but devastating complication in deep inferior epigastric perforator (DIEP) flap reconstructions. Common causes of partial or complete flap failure are related to venous congestion. Although the cephalic vein is usually a safe and reliable recipient vein for additional venous o...

Full description

Saved in:
Bibliographic Details
Published inPlastic and reconstructive surgery (1963) Vol. 151; no. 1; p. 195
Main Authors Svee, Andreas, Falk-Delgado, Alberto, Folkvaljon, Folke, Cederland, Christoffer, Wallenius, Imke, Audolfsson, Thorir, Drazan, Lubos, Mani, Maria
Format Journal Article
LanguageEnglish
Published United States 01.01.2023
Subjects
Online AccessGet more information

Cover

Loading…
Abstract Flap failure is a rare but devastating complication in deep inferior epigastric perforator (DIEP) flap reconstructions. Common causes of partial or complete flap failure are related to venous congestion. Although the cephalic vein is usually a safe and reliable recipient vein for additional venous outflow, there is a hypothesized risk of donor-arm lymphedema secondary to lymphatic vessel damage in the vicinity of the cephalic vein or related to scarring and reduced venous backflow of the arm. The aim was to assess whether the cephalic vein as an additional recipient vessel, by means of the superficial inferior epigastric vein in DIEP flap breast reconstruction, was associated with long-term volume changes of the arm and/or symptoms of lymphedema. Arm volume was assessed preoperatively in patients scheduled to undergo unilateral delayed DIEP flap breast reconstruction at Uppsala University Hospital, Sweden, between 2001 and 2007. Long-term postoperative assessments were performed in 2015 to 2016. Water displacement and circumferential measurement were assessed preoperatively and postoperatively by the same lymphedema therapists. Patients were divided into two groups: DIEP reconstruction with the cephalic vein or without. Fifty-four patients fulfilled the inclusion criteria and completed the study, with a mean follow-up time of 136 months. There was no increased occurrence of lymphedema in the group undergoing DIEP flap reconstruction with the cephalic vein as extra venous drainage, based on an analysis of change from baseline in arm volume difference.This study shows that the cephalic vein can be used for secondary venous outflow in DIEP breast reconstruction without long-term risk of ipsilateral arm volume increase or symptoms of lymphedema. Risk, II.
AbstractList Flap failure is a rare but devastating complication in deep inferior epigastric perforator (DIEP) flap reconstructions. Common causes of partial or complete flap failure are related to venous congestion. Although the cephalic vein is usually a safe and reliable recipient vein for additional venous outflow, there is a hypothesized risk of donor-arm lymphedema secondary to lymphatic vessel damage in the vicinity of the cephalic vein or related to scarring and reduced venous backflow of the arm. The aim was to assess whether the cephalic vein as an additional recipient vessel, by means of the superficial inferior epigastric vein in DIEP flap breast reconstruction, was associated with long-term volume changes of the arm and/or symptoms of lymphedema. Arm volume was assessed preoperatively in patients scheduled to undergo unilateral delayed DIEP flap breast reconstruction at Uppsala University Hospital, Sweden, between 2001 and 2007. Long-term postoperative assessments were performed in 2015 to 2016. Water displacement and circumferential measurement were assessed preoperatively and postoperatively by the same lymphedema therapists. Patients were divided into two groups: DIEP reconstruction with the cephalic vein or without. Fifty-four patients fulfilled the inclusion criteria and completed the study, with a mean follow-up time of 136 months. There was no increased occurrence of lymphedema in the group undergoing DIEP flap reconstruction with the cephalic vein as extra venous drainage, based on an analysis of change from baseline in arm volume difference.This study shows that the cephalic vein can be used for secondary venous outflow in DIEP breast reconstruction without long-term risk of ipsilateral arm volume increase or symptoms of lymphedema. Risk, II.
Author Falk-Delgado, Alberto
Folkvaljon, Folke
Cederland, Christoffer
Audolfsson, Thorir
Drazan, Lubos
Wallenius, Imke
Mani, Maria
Svee, Andreas
Author_xml – sequence: 1
  givenname: Andreas
  surname: Svee
  fullname: Svee, Andreas
  organization: Department of Surgical Sciences, Uppsala University
– sequence: 2
  givenname: Alberto
  surname: Falk-Delgado
  fullname: Falk-Delgado, Alberto
  organization: Plastic and Craniofacial Surgery, Karolinska University Hospital
– sequence: 3
  givenname: Folke
  surname: Folkvaljon
  fullname: Folkvaljon, Folke
  organization: Sveastat AB
– sequence: 4
  givenname: Christoffer
  surname: Cederland
  fullname: Cederland, Christoffer
  organization: From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital
– sequence: 5
  givenname: Imke
  surname: Wallenius
  fullname: Wallenius, Imke
  organization: From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital
– sequence: 6
  givenname: Thorir
  surname: Audolfsson
  fullname: Audolfsson, Thorir
  organization: Department of Plastic Surgery and Reconstructive Surgery, Landspitali University Hospital
– sequence: 7
  givenname: Lubos
  surname: Drazan
  fullname: Drazan, Lubos
  organization: Clinic of Plastic and Aesthetic Surgery, Faculty Hospital St. Anne's
– sequence: 8
  givenname: Maria
  surname: Mani
  fullname: Mani, Maria
  organization: Department of Surgical Sciences, Uppsala University
BackLink https://www.ncbi.nlm.nih.gov/pubmed/36251837$$D View this record in MEDLINE/PubMed
BookMark eNpNj9tKAzEYhIMo9qBvIJIX2JrD7iZ7WWvVhaKlWm_Lv8kfuronku1F374tWnAYmIsZPpgRuWzaBgm542zCWaYelquPCfunTKXZBRnyRGRRLGIxIKMQvhnjSqbJNRnIVCRcSzUkfh2Qto72W6Qz7LZQlYZ-YdnQo5_y-ZI-eoTQ0xWatgm935m-bI9Vi4G-tT3NG3MaIF2V4edEWuzrbosWazhz8y6UFfTooaJTX9-QKwdVwNu_HJP18_xz9hot3l_y2XQRGckzFUGRgNOx0gw0yxILhWWxRiW0jUHFwFlhHCvQuURbKYUyqXBgU8VsGmvpxJjc_3K7XVGj3XS-rMHvN-fz4gDkd1zA
CitedBy_id crossref_primary_10_1186_s12957_023_03254_9
ContentType Journal Article
Copyright Copyright © 2022 by the American Society of Plastic Surgeons.
Copyright_xml – notice: Copyright © 2022 by the American Society of Plastic Surgeons.
DBID CGR
CUY
CVF
ECM
EIF
NPM
DOI 10.1097/PRS.0000000000009769
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
DatabaseTitleList MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod no_fulltext_linktorsrc
Discipline Medicine
EISSN 1529-4242
ExternalDocumentID 36251837
Genre Journal Article
GroupedDBID ---
.-D
.XZ
.Z2
01R
0R~
123
1J1
354
40H
4Q1
4Q2
4Q3
53G
5RE
5VS
71W
77Y
7O~
AAAAV
AAAXR
AAGIX
AAHPQ
AAIQE
AAMOA
AAMTA
AAQKA
AARTV
AASCR
AASOK
AASXQ
AAUEB
AAXQO
ABASU
ABBUW
ABDIG
ABJNI
ABOCM
ABVCZ
ABXVJ
ABZAD
ACDDN
ACEWG
ACGFO
ACGFS
ACILI
ACLDA
ACNWC
ACOAL
ACWDW
ACWRI
ACXJB
ACXNZ
ADGGA
ADHPY
AE6
AENEX
AFDTB
AFSOK
AFUWQ
AGINI
AHOMT
AHQNM
AHVBC
AIJEX
AINUH
AJIOK
AJNWD
AJZMW
AKULP
ALMA_UNASSIGNED_HOLDINGS
ALMTX
AMJPA
AMKUR
AMNEI
AOHHW
AWKKM
BOYCO
BQLVK
BYPQX
C45
CGR
CS3
CUY
CVF
DIWNM
DU5
E.X
EBS
ECM
EEVPB
EIF
ERAAH
EX3
F2K
F2L
F2M
F2N
F5P
FCALG
FL-
GNXGY
GQDEL
H0~
HLJTE
HZ~
IKREB
IKYAY
IN~
IPNFZ
JF7
JK3
K8S
KD2
KMI
L-C
L7B
N9A
NPM
N~7
N~B
O9-
OAG
OAH
OBH
ODA
OHH
OJAPA
OL1
OLB
OLG
OLH
OLU
OLV
OLW
OLY
OLZ
OPUJH
OVD
OVDNE
OVIDH
OVLEI
OVOZU
OWU
OWV
OWW
OWX
OWY
OWZ
OXXIT
P2P
RIG
RLZ
RXW
S4R
S4S
TAF
TEORI
TSPGW
TWZ
V2I
VVN
W3M
WH7
WOQ
WOW
X3V
X3W
XXN
XYM
YOC
ZFV
ZY1
ID FETCH-LOGICAL-c3197-ab5af84780a8095dabd048e728d4a74a10bcf0beff58d3327c62fad670d6483f2
IngestDate Wed Oct 16 00:39:47 EDT 2024
IsPeerReviewed true
IsScholarly true
Issue 1
Language English
License Copyright © 2022 by the American Society of Plastic Surgeons.
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c3197-ab5af84780a8095dabd048e728d4a74a10bcf0beff58d3327c62fad670d6483f2
PMID 36251837
ParticipantIDs pubmed_primary_36251837
PublicationCentury 2000
PublicationDate 2023-01-01
PublicationDateYYYYMMDD 2023-01-01
PublicationDate_xml – month: 01
  year: 2023
  text: 2023-01-01
  day: 01
PublicationDecade 2020
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle Plastic and reconstructive surgery (1963)
PublicationTitleAlternate Plast Reconstr Surg
PublicationYear 2023
SSID ssj0017365
Score 2.4563105
Snippet Flap failure is a rare but devastating complication in deep inferior epigastric perforator (DIEP) flap reconstructions. Common causes of partial or complete...
SourceID pubmed
SourceType Index Database
StartPage 195
SubjectTerms Epigastric Arteries - surgery
Humans
Hyperemia - etiology
Iliac Vein - surgery
Lymphedema - complications
Lymphedema - surgery
Mammaplasty - adverse effects
Perforator Flap - blood supply
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative Complications - surgery
Regional Blood Flow
Retrospective Studies
Title Use of the Cephalic Vein in DIEP Breast Reconstruction Does Not Increase Risk of Lymphedema of the Ipsilateral Arm
URI https://www.ncbi.nlm.nih.gov/pubmed/36251837
Volume 151
hasFullText
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1bb9MwFLY6kKa9IO4wLvIDb1MgcZw4eUQFNBCbqm1Fe5t8hbG2qdpuEvw8fhnnxHaTjSEuVRW1cXQa-Xw9_nxyLoS8yK1RotY84Rq9VTrLE1WWaSKZrtDtkZc15g7v7Ze7Y_7huDgeDH70opbOV-ql_n5tXsn_aBXOgV4xS_YfNLsWCifgM-gXjqBhOP6VjsfL9TP-oZ1_kViw-pM9bYMXgeeNQHPYmge5YdNVigXSbMG6NSs0DniB3TkIAeYfv4FyrbFTGeW-ny9PJxLTlEGVi2mfy46AeMdyr4veL1zYnaVPtm6rQMF_r-duOLzwkT9tIKXskk_k5Cx5YyefpQl5Nxjw3XRr5OQMJu6rDxHAb2s8DrEaRgzPDKUSsOdL353B8p47wwYTzOqEM37ZRoeqtH0weoub-R6dv6wEvsLw6ODQV6gMLyBfdf9y0Od82qIDFvICzJv48-iV-txxaINsiAqbh-yjvyg8xxJ5WcSEzVq8uu52tshmFHFla9NSnKPb5FbYm9DXHmh3yMDO7pLNvRB9cY8sAG-0cRRwQSPeKOKNwhvxRj3e6GW8UcQbBbzRiDeKeENJHd6i3B7e4Eam98n43duj4W4SenYkGoy5SKQqpAPGU6WyAvZupDKwRljBKsOl4DJLlXapss4VlclzJnTJnDSlSE3Jq9yxB-TGrJnZR4RKlZYsU5ljOuOmAFIBYjLlDGzCU635Y_LQz9bJ3BdmOYnzuP3bkSdkqwPdU3LTgSWwz4BWrtTzVnM_AWVpdi0
link.rule.ids 780
linkProvider National Library of Medicine
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Use+of+the+Cephalic+Vein+in+DIEP+Breast+Reconstruction+Does+Not+Increase+Risk+of+Lymphedema+of+the+Ipsilateral+Arm&rft.jtitle=Plastic+and+reconstructive+surgery+%281963%29&rft.au=Svee%2C+Andreas&rft.au=Falk-Delgado%2C+Alberto&rft.au=Folkvaljon%2C+Folke&rft.au=Cederland%2C+Christoffer&rft.date=2023-01-01&rft.eissn=1529-4242&rft.volume=151&rft.issue=1&rft.spage=195&rft_id=info:doi/10.1097%2FPRS.0000000000009769&rft_id=info%3Apmid%2F36251837&rft_id=info%3Apmid%2F36251837&rft.externalDocID=36251837