Preoperative assessment of the superficial epigastric venous system in large DIEP flaps for breast reconstruction: The role of the midline venous crossover in SIEV selection.

Venous congestion remains a clinically relevant determinant of morbidity in deep inferior epigastric perforator flap breast reconstruction, particularly when large flaps are needed and extend beyond the abdominal midline.

This study evaluated whether preoperative computed tomography angiography grading of superficial epigastric venous midline crossover could guide superficial inferior epigastric vein drainage when additional venous outflow was required.