ABSTRACT
The benefits of laser-assisted indocyanine green fluorescence angiography have previously
been demonstrated in cardiac surgery. The purpose of this study was to determine the
value of this technology in microsurgical breast reconstruction. Intraoperative laser-assisted
indocyanine green fluorescence angiography was performed on all microsurgical breast
reconstruction cases (deep inferior epigastric perforator flap or free transverse
rectus abdominus muscle flap) during the study period. Ten consecutive free tissue
transfer autologous breast reconstructions were performed on 8 women. In four cases,
imaging demonstrated flow or perfusion deemed “marginal” or “poor” by the operating
surgeons. In three of these cases, one involving poor arterial inflow, one of poor
venous outflow, and one of poor perfusion of a mastectomy flap, the intraoperative
plan was adjusted accordingly and follow-up imaging demonstrated improvement. In the
fourth case, no adjustment was made at operation. However this patient required a
return to the operating room for venous congestion of the flap, which was corrected
without sequela. Overall flap survival was 100%. We concluded that laser-assisted
indocyanine green fluorescence angiography appears to provide important information
that has helped guide intraoperative decision making in our series.
KEYWORDS
Breast - microsurgery - reconstruction - angiography - indocyanine green fluorescence
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Martin I NewmanM.D. F.A.C.S.
Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida
2950 Cleveland Clinic Blvd., Weston, FL 33331
Email: newmanm@ccf.org
