Summary
Introduction
The rib-sparing technique to access the internal mammary vessels for microanastomosis
is the current practice in our hospital nowadays. This study is performed to analyse
the best intercostal space to expose those vessels.
Patients and methods
Magnetic resonance imaging (MRI) of the chest wall of 133 women was evaluated. The
Schwabegger classification (representing the anatomical variation), the intercostal
space between ribs two, three and four, and the surface of the internal mammary artery
and veins in the second and third intercostal space were determined on multiplanar
reconstructed T2-weighted images.
Results
In more than half of the cases, the anatomy followed Schwabegger variation two; one
lateral artery and one medial vein were symmetrical. If a second vein was present,
the bifurcation was most commonly in the third intercostal space. The second intercostal
space above the mammary vessels was significantly wider than the third one. The surface
of the artery and vein(s) was significantly larger in the second intercostal space.
Conclusion
In most clinical situations, 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 artery and vein.
Keywords
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Article info
Publication history
Published online: June 13, 2012
Accepted:
April 26,
2012
Received:
December 16,
2011
Footnotes
☆The work was presented at the following meetings: NVPC Meeting April 2011 (National Meeting of the Dutch Society of Plastic Surgery), WSRM 2011 (Biannual Meeting of the World Society of Reconstructive Microsurgery), Meeting of the Italian Society of Microsurgery 2011.
☆☆The work should be attributed to MUMC+ Maastricht (NL).
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
