Chapter 11 inferior epigastric artery and vein, constituting the pedicle of the DIEP (deep inferior epigastric perforator) flap. MRA is the gold standard in our hospital for preoperative imaging in perforator flap surgery. We found 100% agreement between EP CE-MRA and surgical findings in identifying the best perforator branch on both sides of the abdomen. In chapter 8 the presence of septocutaneous perforators around the tensor fasciae latae flap led us to the description of the sc-TFL flap for breast reconstruction. 60 MRA were analysed and 5 flaps were successfully done in 4 patients. In chapter 9 additionally the most common recipient vessels in perforator flap surgery, the internal mammary artery and vein, were evaluated on mag- netic resonance imaging (MRI). The rib-sparing approach to the internal mammary vessels has become more and more popular than the standard one with removal of the third rib which may cause pain, tenderness and thoracic contour deformity. We objectively described that, from a pure technical point of view, the second intercostal space is most likely the best approach to the internal mammary vessels for microanastomosis using a rib-sparing technique because of wider intercostal space and larger diameter of the artery and vein. 173
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