The Use of Indocyanine Green Angiography in Breast Reconstruction

Sood, Mohit

doi:10.1007/978-3-319-18726-6_20

Cited by 1 publication

(3 citation statements)

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“…ICG-FA is probably the most widely used method for intraoperative evaluation of tissue microvascular blood flow in reconstructive plastic surgery today. 6,7,[19][20][21][22][23] The method is primarily used as a visual aid and decision support when raising free flaps or evaluating skin flaps in breast surgery. Unfortunately, like many other new surgical methods and tools, ICG-FA has been introduced without being evaluated to the extent desired.…”

Section: Discussionmentioning

confidence: 99%

“…It is possible to give repeated injections, but for each assessment a new dose must be given, and if dye is remaining in the tissue, the data may be harder to evaluate. [4][5][6][7] It would be preferable to use a method that gives a similar picture of the microvascular blood flow of the flap, without the need of repeated ICG injections. In previous studies, we have used laser speckle contrast imaging (LSCI) to assess the microvascular blood flow in deep inferior epigastric perforator (DIEP) free flaps intraoperatively.…”

Section: Introductionmentioning

confidence: 99%

“…It is possible to give repeated injections, but for each assessment a new dose must be given, and if dye is remaining in the tissue, the data may be harder to evaluate. 4–7…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Indocyanine Green Fluorescence Angiography and Laser Speckle Contrast Imaging in a Flap Model

Zötterman,

Tesselaar,

Elawa

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Indocyanine green fluorescence angiography (ICG-FA) is used to assess tissue intraoperatively in reconstructive surgery. This requires an intra-venous dye injection for each assessment. This is not necessary in laser speckle contrast imaging (LSCI); therefore, this method may be better suited for tissue evaluation. To determine this, we compared the two methods in a porcine flap model. Methods: One random and one pedicled flap were raised on each buttock of six animals. They were assessed with LSCI at baseline, when raised (T0), at 30 minutes (T30) and with ICG-FA at T0 and T30. Regions of interest (ROI) were chosen along the flap axis. Perfusion, measured as perfusion units (PU) in the LSCI assessment and pixel-intensity for the ICG-FA video uptake, was calculated in the ROI. Correlation was calculated between PU and pixel-intensity measured as time to peak (TTP) and area under curve for 60 seconds (AUC60). Results: Correlation between LSCI and AUC60 for the ICG-FA in corresponding ROI could be seen in all flaps at all time points. The correlation was higher for T0 (r=0.7 for random flap and r=0.6 for pedicled flap) than for T30 (r=0.57 for random flap and r=0.59 for pedicled flap). Even higher correlation could be seen PU and TTP (T0: random flap r=-0.8 and pedicled flap r=0.76. T30: random flap r=-0.8 and pedicled flap r=0.71) Conclusion: There is a correlation between PU from LSCI and TTP and AUC60 for ICG-FA, indicating that LSCI could be considered for intraoperative tissue assessment.

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