Pilot Assessment of the Angiosome Concept by Intra-operative Fluorescence Angiography After Tibial Bypass Surgery

Abstract

Microcirculatory improvement was seen over the whole foot after tibial bypass. Therefore, fluorescence angiography is a promising tool to evaluate the angiosome concept in future larger studies. Clinicaltrials.gov: NCT03012750.

Current Issues and Interrogations in Angiosome Wound Targeted Revascularization for Chronic Limb Threatening Ischemia: A Review

“…This paper reveals better and quicker healing results for intentional endovascular DR, however with no significant difference in limb salvage and amputation free survival between groups [89]. In another up-to-date 40 cases prospective analysis, Rother et al [90] found a notable difference in "time to healing" for bypass that was superior in DR against IR. The authors observed yet no meaningful significance in immediate microcirculation changes between the studied groups [90].…”

“…In another up-to-date 40 cases prospective analysis, Rother et al [90] found a notable difference in "time to healing" for bypass that was superior in DR against IR. The authors observed yet no meaningful significance in immediate microcirculation changes between the studied groups [90]. These two recent prospective studies seem but to confirm previous retrospective tissue healing observations about quicker median time to "tissue recovery" following DR/WTR Recent clinical correlations.…”

When free flaps are not the first choice: is the distally based peroneus brevis still an option for foot and ankle reconstruction in the era of microsurgery?

“…Methods of tissue engineering and regenerative medicine [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] to circumvent the use of autologous tissue and their inherent donor site morbidity seem promising but are not clinically available for these problems yet. Although a considerable number of local or free flaps has been successfully described to surgically reconstruct these defects [7,[52][53][54][55][56][57][58] each individual case needs the optimal indication for the most suitable flap procedure. Free flap transfer has become a routine method in high volume centers and allow free tissue transfer even to the distal lower extremity with a successful closure in more than 90%-95%, depending on the comorbidities and local and systemic conditions.…”

Der sichere Lappen – Präoperatives Gefäß-Mapping und intraoperative Perfusionsmessung zur Reduktion der lappenbedingten Morbidität

“…Neben der Wahl eines geeigneten Perforators ist die intraoperative Beurteilung der Perfusion einer Lappenplastik entscheidend um lappenbedingte Komplikationen zu vermeiden. Anhand von ICG-Fluoreszenzangiographie, Laser-Doppler Spektrometrie, dynamischer Infrarot-Thermografie und Photospektrometrie kann die Gewebeperfusion objektiv dargestellt werden [33][34][35][36]. In Anbetracht der Tatsache, dass die ICG-Fluoreszenzangiographie das hierbei mit Abstand am häufigsten verwendete Tool ist, was sich auch in unserem Konsensus Workshop bestätigte, wird im Folgenden lediglich diese Methode diskutiert.…”