The topographical anatomy of the inferior epigastric artery and its perforating branches in the computed tomography angiography - significance for reconstructive surgery.

[BACKGROUND] The aim of this study was to provide a detailed analysis of the topographical anatomy of the inferior epigastric artery (IEA), including its origin pattern, morphometric parameters, spatial relationships to anatomical landmarks and perforating branches.

[MATERIALS AND METHODS] Data from 75 patients who underwent computed tomographic angiography of the abdomen and pelvis were analyzed. A total of 142 sides that met the eligibility criteria were evaluated.

[RESULTS] The IEA was found to originate from the external iliac artery in 110 cases (77.5%), in 22 cases (15.5%) it had a common trunk with the obturator artery, in 9 cases (6.3%) it originates from the femoral artery, and in one case (0.7%) from the deep femoral artery. The median diameter of the IEA at its origin was 3.12 mm, while its cross-sectional area was 5.97 mm². The median distance between the origin of the source artery to the origin of the IEA was 8.46 mm. The number of perforators varies per patient side from 2 to 7, with the most common direction of their origin being the medial direction.

[CONCLUSIONS] The most common origin was the external iliac artery (77.5%), although a common trunk with the obturator artery was also observed relatively often (15.5%). The IEA originated most commonly in the medial direction (93.0%). A key focus was on the perforators, with a median of 2 per side and up to 7 observed. The first perforator that could be used in the deep inferior artery perforator (DIEP) flap had a mean diameter of 1.71 mm and was located approximately 64.6 mm from the IEA origin and 95.3 mm from the umbilicus. The obtained results may find clinical application during pedicle preparation during DIEP flap elevation and in penile revascularization procedures.