DIEP flap customization using Fluobeam ® indocyanine green tissue perfusion assessment with large previous abdominal scar

Fallucco, Michael; Snell, Colin P.; Desai, Ankit R.

doi:10.1016/j.jpra.2017.02.003

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…This could be verified by placing and releasing sequentially vascular clamps on the perforators and scan the perforasome. 39 Imaging following completion of anastomosis can demonstrate good arterial and venous patency and supports the clinical judgement about which part of the flap is poor perfused and should be discarded during flap trimming. [40][41][42][43] A sparsity of studies investigating ICG-angiography for perforator imaging.…”

Section: Fluorescence Near-infrared Angiography (Fa)mentioning

confidence: 61%

Alternative imaging technologies for perforator mapping in free flap breast reconstructive surgery – A comprehensive overview of the current literature

Steenbeek

Peperkamp

Ulrich

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Fluorescence Near-infrared Angiography (Fa)mentioning

confidence: 61%

Alternative imaging technologies for perforator mapping in free flap breast reconstructive surgery – A comprehensive overview of the current literature

Steenbeek

Peperkamp

Ulrich

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…These are not only for open surgery procedures, but also for laparoscopic, thoracoscopic, and robotic surgery. Examples of the currently available intraoperative systems are: PDE ® manufactured by Hamamatsu [11], the SPY fluorescence imaging system by Novadaq [12], the FLARE TM system from the Frangioni Laboratory [13], and Fluobeam ® developed by Fluoptics [14]. The Artemis, a recent imaging system developed for real-time guidance during surgery, has been developed by Quest Medical Imaging (Essex UK) and the Leiden University Medical Centre in Holland [15].…”

Section: Jinst 14 P07007mentioning

confidence: 99%

Characterisation of a near-infrared (NIR) fluorescence imaging systems intended for hybrid gamma-NIR fluorescence image guided surgery

et al. 2019

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A novel hand-held hybrid optical-gamma camera (HGC) has previously been described that is capable of displaying co-aligned images from both modalities in a single imaging system. Here, a dedicated NIR imaging system for NIR fluorescence surgical guidance has been developed for combination with the HGC . This work has evaluated the performance of two NIR fluorescence imaging systems using phantom studies, various fluorophores and various experimental configurations. The threshold detectable concentration of ICG and 800CW dyes were investigated for both systems. Bespoke lymph node phantoms simulating metastases and tissue-like layers were constructed to evaluate the detection capability. ICG could be detected at a minimum concentration of 1 μM for each camera. The lower thresholds for 800CW were 10−2 and 10−3 μM for the modified and NIR cameras, respectively. Both cameras were unable to detect small-sized targets within a 3 mm depth, but were able to identify larger targets as deep as 7 mm. Further improvements are required to optimise the NIR-fluorescence systems for subsequent combination with the HGC to undertake dual gamma-NIR fluorescence intraoperative imaging.

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Prospective Clinical Trial for Predicting Mastectomy Skin Flap Necrosis with Indocyanine Green Angiography in Implant-Based Prepectoral Breast Reconstruction

Kim,

Han,

Hong

2024

Aesth Plast Surg

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Background Indocyanine green angiography (ICG-A) is a useful tool for evaluating mastectomy skin flap (MSF) perfusion during breast reconstruction. However, a standardized protocol for interpreting and applying MSF perfusion after mastectomy has not been established yet. The purpose of this study is to establish criteria for assessing MSF perfusion in immediate implant-based prepectoral breast reconstruction while correlating ICG-A findings with postoperative outcomes Methods This prospective observational study was conducted at a single institution and involved patients with breast cancer who underwent mastectomy and immediate implant-based prepectoral breast reconstruction between August 2021 and August 2023. The terms “hypoperfused flap” and “hypoperfused area” were defined according to ICG-A perfusion. MSF exhibited < 30% perfusion, excluding the nipple and the corresponding region, respectively. Data on the hypoperfused flap, hypoperfused area, and MSF necrosis were collected. Results Fifty-three breast cases were analyzed. Eight patients developed MSF necrosis (15.1%, 8/53). Of these, two patients underwent surgical debridement and revision within 3 months (3.8%, 2/53). There were nine cases of a hypoperfused flap, eight of which developed MSF necrosis. The hypoperfused flap was a significant predictor of the occurrence of MSF necrosis (p < 0.001). There was a tendency for increased full-thickness necrosis with a wider hypoperfused area. Conclusions The hypoperfused flap enabled the prediction of MSF necrosis with high sensitivity, specificity, positive predictive value, and negative predictive value. Considering the presumed correlation between the extent of the hypoperfused area and the need for revision surgery, caution should be exercised when making intraoperative decisions regarding the reconstruction method. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

show abstract

DIEP flap customization using Fluobeam ® indocyanine green tissue perfusion assessment with large previous abdominal scar

Cited by 4 publications

References 5 publications

Alternative imaging technologies for perforator mapping in free flap breast reconstructive surgery – A comprehensive overview of the current literature

Alternative imaging technologies for perforator mapping in free flap breast reconstructive surgery – A comprehensive overview of the current literature

Characterisation of a near-infrared (NIR) fluorescence imaging systems intended for hybrid gamma-NIR fluorescence image guided surgery

Prospective Clinical Trial for Predicting Mastectomy Skin Flap Necrosis with Indocyanine Green Angiography in Implant-Based Prepectoral Breast Reconstruction

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