Abstract
Background Given the national trends in obesity, reconstructive surgeons are faced with an increasing
number of overweight and obese women interested in postmastectomy breast reconstruction.
While the link between obesity and adverse postoperative outcomes is well established,
few studies have explored the relationship between body mass index (BMI) and the vasculature
of the anterior abdominal wall.
Methods A radiographic review was conducted on female patients who underwent computed tomographic
angiography (CTA) of the anterior abdominal wall. CTA studies were evaluated for perforator
caliber and quantity. Patients were stratified by BMI. The relationship between BMI
and the diameter and number of deep inferior epigastric artery (DIEA) perforators
was analyzed using analysis of variance using Minitab software with α of 0.05.
Results There were a total of 916 hemiabdomens included in this study. There was no statistically
significant correlation between BMI and DIEA diameter or mean diameter of major (≥
1 mm) DIEA perforators. There was a statistically significant negative correlation
between BMI and the number of major DIEA perforators (p < 0.01).
Conclusion Despite the increased demands of excess abdominal adiposity, DIEA perforator caliber
was not correlated with BMI on CTA. The number of major DIEA perforators visualized
on CTA decreased with increasing body weight may indicate a limitation of CTA for
presurgical planning of abdominal free flaps in obese patients.
Keywords deep inferior epigastric artery - body mass index - computed tomographic angiography
