Background: Arterial grafts are used routinely by cardiovascular surgeons as an ideal conduit. Veins are used as ideal conduits in the lower extremities by vascular surgeons, but microvascular surgeons have not yet agreed on the ideal conduit for use in microvascular bypass surgery. We propose the deep inferior epigastric artery (DIEA) as a preferred conduit.

Materials and Methods: We conducted an anatomical study using preserved cadavers. Sixty-three deep inferior epigastric arteries (DIEA) were dissected from 34 cadavers. The artery was dissected from its origin, and was followed proximally until the external diameter decreased to one millimeter.

Results: The mean length was 14.06 cm (SD 2.54), while the diameter of the origin had a mean of 2.94 mm (SD 0.44). The DIEA has been used in seven clinical cases as an arterial conduit to bypass distal to the wrist. All seven bypasses were patent one year post-operatively, without donor site complications.

Conclusion: The DIEA is a morphologically reliable source of arterial grafts. The advantages include anatomic taper, improved size match, better handling characteristics, and superior patency.