Intraoperative real-time assessment of blood flow using indocyanine green angiography after anastomoses in free-flap reconstructions

Eguchi, Takanori; Kawaguchi, Kouji; Basugi, Akihiko; Kanai, Ikuyo; Hamada, Y.

doi:10.1016/j.bjoms.2017.03.011

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Microvascular Indocyanine Green Angiography (mICG-A) combined with the microscope-integrated software FLOW800 provides valuable information on vascular patency and enables the real-time visualization of arterial in- and venous outflow in free flaps [ 42 , 43 , 44 ]. It is a matter of common pathophysiological knowledge that the alteration in blood flow, as part of the Virchow’s triad, is a main contributor to thrombus formation in blood vessels [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Blood Flow Analysis of DIEP vs. ms-TRAM Flap Breast Reconstruction Combining Transit-Time Flowmetry and Microvascular Indocyanine Green Angiography

Geierlehner

Horch

Ludolph

et al. 2022

JPM

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Background: Vascular patency is the key element for high flap survival rates. The purpose of this study was to assess and compare the blood flow characteristics of deep inferior epigastric perforator (DIEP) and muscle-sparing transverse rectus abdominis musculocutaneous (ms-TRAM) flaps for autologous breast reconstruction. Methods: This prospective clinical study combined Transit-Time Flowmetry and microvascular Indocyanine Green Angiography for the measurement of blood flow volume, vascular resistance, and intrinsic transit time. Results: Twenty female patients (mean age, 52 years) received 24 free flaps (14 DIEP and 10 ms-TRAM flaps). The mean arterial blood flow of the flap in situ was 7.2 ± 1.9 mL/min in DIEP flaps and 11.5 ± 4.8 mL/min in ms-TRAM flaps (p < 0.05). After anastomosis, the mean arterial blood flow was 9.7 ± 5.6 mL/min in DIEP flaps and 13.5 ± 4.2 mL/min in ms-TRAM flaps (p = 0.07). The arterial vascular resistance of DIEP flaps was significantly higher than that of ms-TRAM flaps. The intrinsic transit time of DIEP flaps was 52 ± 18 s, and that of ms-TRAM flaps was 33 ± 11 s (p < 0.05). The flap survival rate was 100%. One DIEP flap with the highest intrinsic transit time (77 s) required surgical revision due to arterial thrombosis. Conclusion: In this study, we established the blood flow characteristics of free DIEP and ms-TRAM flaps showing different blood flow rates, vascular resistances, and intrinsic transit times. These standard values will help to determine the predictive values for vascular compromise, hence improving the safety of autologous breast reconstruction procedures.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Blood Flow Analysis of DIEP vs. ms-TRAM Flap Breast Reconstruction Combining Transit-Time Flowmetry and Microvascular Indocyanine Green Angiography

Geierlehner

Horch

Ludolph

et al. 2022

JPM

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“…ICG angiography is used in a range of surgeries, such as for free flaps e.g. in head and neck surgery (35), in the field of upper extremity surgery (36), for assessing parathyroid perfusion during thyroidectomy (37), for breast reconstruction (38), but also for uterine vascular perfusion at the time of radical trachelectomy (39) and organ transplantations (40). Beran et al used ICG after cervico-vaginal anastomosis in baboons to document real-time vascular perfusion of the uterus with utero-ovarian perfusion alone (41,42).…”

Section: Discussionmentioning

confidence: 99%

Intra- and Postoperative Blood Flow Monitoring in a Sheep Model of Uterus Transplantation

Kengelbach‐Weigand

Lotz

Schmid

et al. 2019

In Vivo

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“…Subsequently, ICG angiography has been used to identify sentinel lymph nodes (37), determine the extent of oncologic resections (38), and study hepatic function (39). Recent studies have also demonstrated its usefulness in evaluating the vascular blood flow of intestinal anastomoses (40) and tissue flap reconstructions (41).…”

Section: Fluorescent Techniques With Icg In Neck Surgerymentioning

confidence: 99%

A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques

Sadowski¹,

Fortuny²,

Triponez³

2017

Gland Surg.

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Intraoperative real-time assessment of blood flow using indocyanine green angiography after anastomoses in free-flap reconstructions

Cited by 9 publications

References 5 publications

Intraoperative Blood Flow Analysis of DIEP vs. ms-TRAM Flap Breast Reconstruction Combining Transit-Time Flowmetry and Microvascular Indocyanine Green Angiography

Intraoperative Blood Flow Analysis of DIEP vs. ms-TRAM Flap Breast Reconstruction Combining Transit-Time Flowmetry and Microvascular Indocyanine Green Angiography

Intra- and Postoperative Blood Flow Monitoring in a Sheep Model of Uterus Transplantation

A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques

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