Laser-assisted indocyanine green angiography in implant-based immediate breast reconstruction: a retrospective study

Hammer-Hansen, Niels; Juhl, Alexander Andersen; Damsgaard, Tine Engberg

doi:10.1080/2000656x.2017.1372289

Cited by 27 publications

(39 citation statements)

References 24 publications

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“…The individual outcomes of studies are presented in Table . All of the included papers used as an outcome the occurrence of necrosis . One of the included trials did not use infection as an outcome .…”

Section: Resultsmentioning

confidence: 99%

“…One of the included trials did not use infection as an outcome . Five papers did not use seroma as clinical outcome . Three of the studies did not use as an outcome the necessity of reoperation …”

Section: Resultsmentioning

confidence: 99%

“…Four studies showed that the use of LAIGA promotes the reduction of necrosis; one of them showed a significant reduction of infection, and three papers showed a significant reduction of necessity for reoperation …”

Section: Resultsmentioning

confidence: 99%

“…Regarding the reduction of incidence in reoperation for complications, perfusion assessment using LAIGA showed significantly fewer incidents compared to classical clinical evaluation. The only study that reported no difference in reoperation was from Hammer‐Hansen et al However, the LAIGA group had a considerably lower rate of reoperation (9.1% vs 17.7%). The authors attributed this statistical lack to an unpowered sample.…”

Section: Discussionmentioning

confidence: 98%

“…One study was considered to have a high risk of bias, 9 one study was considered to have an unclear risk of bias 7 and the other seven studies were judged to have a low risk of bias [10][11][12][13][14][15][16] ( Figure 2).…”

Section: The Methodological Quality Of the Studiesmentioning

confidence: 99%

See 4 more Smart Citations

Use of laser‐assisted indocyanine green angiography in breast reconstruction: Systematic review and meta‐analysis

Neto

Figueiredo

Moro

et al. 2019

Journal of Surgical Oncology

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Laser‐assisted indocyanine green angiography allows surgeons to determine intraoperative flap perfusion and achieve the best outcomes in breast reconstruction. This study stratified outcomes based on a meta‐analysis of complications including longitudinal trials comparing the clinical assessment of skin flaps during breast reconstruction. Nine studies met inclusion criteria and reported outcomes of interest (n = 2256). The risk of flap necrosis and the necessity of reoperation was statistically significantly higher in the control group.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: The Methodological Quality Of the Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Use of laser‐assisted indocyanine green angiography in breast reconstruction: Systematic review and meta‐analysis

Neto

Figueiredo

Moro

et al. 2019

Journal of Surgical Oncology

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Indocyanine green angiography for preventing postoperative mastectomy skin flap necrosis in immediate breast reconstruction

Pruimboom

Schols

Kuijk

et al. 2020

Cochrane Database of Systematic Reviews

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Clinical and Cost‐Effectiveness of Intraoperative Flap Perfusion Assessment With Indocyanine Green Fluorescence Angiography in Breast and Head and Neck Reconstructions: A Systematic Review and Meta‐Analysis

Singaravelu,

McCarrick,

Potter

et al. 2024

Microsurgery

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BackgroundIndocyanine green fluorescence angiography (ICGFA) is gaining popularity for the assessment of reconstructive flap perfusion intraoperatively. This study analyses the literature with a focus on its clinical efficacy and cost‐effectiveness across various plastic and reconstructive surgery procedures.MethodsA systematic review was conducted in accordance with PRISMA guidelines on published studies in English comparing ICGFA with standard clinical assessment for flap perfusion. Meta‐analysis concerned perfusion‐related complications and cost data.ResultsTwenty‐five studies met the inclusion criteria, of which two were randomized controlled trials (RCTs) and four were prospective cohort studies. Twenty‐one studies were AHRQ Standard ‘Good’; however, the overall level of evidence remains low. ICGFA was predominantly performed in breast surgeries (n = 3310) and head and neck reconstruction (n = 701) albeit with inconsistency in protocols and predominantly subjective interpretations (only five studies utilized objective thresholds). In breast surgery, meta‐analysis demonstrated significant reductions in mastectomy skin flap necrosis (odds ratio (OR) 0.58, p < 0.0001), fat necrosis (OR 0.31, p < 0.001), infection (OR 0.66, p = 0.02), and re‐operation (OR 0.40, p < 0.0001), but no significant decrease in total or partial flap loss (OR 0.78, p = 0.57/OR 0.87, p = 0.56, respectively) or increase in dehiscence (OR 1.55, p = 0.11). In head and neck surgery, ICGFA significantly decreased total flap loss (OR 0.47, p = 0.04), although not partial flap loss (OR 0.37, p = 0.13) and reoperation (OR 0.92, p = 0.73). Lower limb (n = 104) and abdominal wall (n = 95) reconstructive surgeries were much less studied with no significant ICGFA impact. Seven studies reported cost savings with flap surgeries and breast reconstructions, although study heterogeneity precluded meta‐analysis.ConclusionsICGFA appears to be a useful, cost‐effective tool to identify otherwise unsuspected hypoperfusion in breast and head and neck reconstruction. There is a clear need for standardization, however, to avoid bias. Further RCTs are necessary to solidify these promising clinical findings.

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Laser-assisted indocyanine green angiography in implant-based immediate breast reconstruction: a retrospective study

Abstract: Our results differ from previously published studies in that no beneficial effect on necrosis rates of was found after implementing LA-ICGA, possibly due to our limited sample size.

Cited by 27 publications

References 24 publications

Use of laser‐assisted indocyanine green angiography in breast reconstruction: Systematic review and meta‐analysis

Use of laser‐assisted indocyanine green angiography in breast reconstruction: Systematic review and meta‐analysis

Indocyanine green angiography for preventing postoperative mastectomy skin flap necrosis in immediate breast reconstruction

Clinical and Cost‐Effectiveness of Intraoperative Flap Perfusion Assessment With Indocyanine Green Fluorescence Angiography in Breast and Head and Neck Reconstructions: A Systematic Review and Meta‐Analysis

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