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Abstract #4465

Pre-Operative Perforator Flap MRA for Autologous Breast Reconstruction

Nanda Deepa Thimmappa1, Silvina P. Dutruel1, Mengchao Pei1, Joshua L. Levine2, Julie Vasile3, David Greenspun3, Constance Chen3, Christina Rhode4, Christina Y. Ahn5, Robert Allen3, Martin R. Prince1

1Radiology, Weill Cornell Medical College, New York, NY, United States; 2Plastic surgery, The Center for the Advancement of Breast Reconstruction at NYEE, New York, NY, United States; 3Plastic & Reconstructive Surgery, New York, NY, United States; 4NewYork-Presbyterian Hospital/Columbia, New York, NY, United States; 5Plastic surgery, NYU Langone Medical Center, New York, NY, United States

This retrospective analysis explores the accuracy of MRA mapping of perforator vessels for autologous breast reconstruction finding MRA to be accurate within 1 cm in all 107 patients. With pre-operative MRA, the flap necrosis rate decreased to 3% compared to an historical average of 14% in the literature. Importantly MR also detected occult metastatic disease in 4 patients. Finally, an automated method of calculating perforator coordinates is presented which eliminated typographical errors associated with manual reporting.