Microcirculation Evaluated by Intraoperative Fluorescence Angiography after Tibial Bypass Surgery

Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease

“…Additionally, the time-dependent ingress rate was used, describing the SFI from the onset of measured fl uorescent intensity until a plateau was reached [5,7,8]. In another study Igari et al used the ICG-FI for the evaluation of tissue perfusion in patients with PAD by using very similar parameters such as the magnitude of intensity of ICG, the time to maximum intensity, and the time from fl uorescent onset to half the maximum intensity [6].…”

“…Previous studies used the software included in the SPY system (NO- VADAQ , Bonita Springs, USA) for quantitative evaluation of foot perfusion before and after revascularization procedures by correlating results to the maximum fl uorescent intensity and time-dependent maximum intensity [5,7,8].…”

“…Some study groups reported successful visual assessment and fi rst attempts in analysing data of blood perfusion using ICG-FI in patients with PAD [5][6][7][8]. To this point, no standardized quantitative assessment of tissue perfusion in vascular surgery has been performed.…”

“…The incidence and prevalence of diabetes mellitus and diabetic foot ulcers are signifi cantly rising [2]. fl ow) of the entire foot, hence providing visual information on the level of micro-perfusion without applying probes or sensors on the skin [5][6][7][8]. Indocyanine green is a dye with an excellent safety profi le and applicable even in patients with renal impairment.…”

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.…”