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

Neto, Edgard da Silva; Figueiredo, Pedro H M; Moro, Marcella Goetz; Oliveira, Ana Paula Ligeiro de; Assumpção, Carolina B; Perina, André; Costa, Fabio Paganini Pereira da; Faria, Eduardo Petribu; Oliveira, André C V de; Prates, Renato Araújo

doi:10.1002/jso.25782

Cited by 12 publications

(3 citation statements)

References 18 publications

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“…Losken et al 13 evaluated flap-based breast reconstructions in 50 patients and concluded that fluorescein dye did predict skin flap necrosis but did underestimate mastectomy skin viability. The study by Phillips et al 14 corroborated these findings reporting that fluorescein dye angiography overpredicted “potential areas of necrosis.” 15,16 Additional studies also reported overprediction of mastectomy skin flap necrosis 17,18 . It is possible that overexcision of skin secondary to predictions by angiography could lead to further complications, which highlights the need to identify appropriate candidates for this form of intraoperative imaging.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Fluorescence Angiography in Implant-Based Breast Reconstruction

et al. 2022

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BackgroundIntraoperative fluorescence angiography (FA) has been described as a useful adjunct to physical examination in predicting mastectomy skin flap viability for immediate breast reconstruction. Its use has been described as a screening tool for mastectomy skin flap viability as well as a test used only for patients at high risk for mastectomy skin flap loss. We performed a national database review of implant-based breast reconstruction surgeries to determine the practice patterns of FA in this patient cohort and to determine if this technology impacted clinical outcomes.MethodsA national insurance claims database was reviewed to select patients having undergone direct-to-implant (DTI) and immediate tissue expander (TE) placement with and without intraoperative FA as well as patients who had FA at the time of mastectomy without reconstruction. Patient characteristics that prompted FA and postoperative outcomes with and without FA were evaluated to determine its clinical impact in the observed practice pattern.ResultsOf the 48,464 patients identified, 836 had FA. More than twice as many patients undergoing DTI had FA than patients undergoing immediate TE placement (10.4% vs 5%, P < 0.0001). Twelve percent of patients receiving FA at the time of mastectomy had reconstruction delayed. Fluorescence angiography was associated with a trend toward lower overall complication rates in DTI patients (8.0% vs 11.9% without FA) but a significantly higher overall complication rate with immediate TE placement (13.8% vs 10.5% without FA, P = 0.018) and was associated with higher reoperation (12.0% vs 8.3% without FA, P = 0.037) in the TE group. There was no difference in other individual complications, readmission, or explantation for either clinical group with and without FA. Regression analysis identified obesity (odds ratio, 1.32; P < 0.001) and younger age (odds ratio, 1.74; P < 0.001) to be associated with performing FA, whereas obesity, diabetes, and tobacco use were associated with higher complication rates.ConclusionsYounger and otherwise healthier obese patients were more likely to have FA. A greater proportion of DTI patients had FA than TE patients with improved outcomes in the former group and worse outcomes in the latter group. Obesity, tobacco use, and diabetes were associated with worse outcomes, whereas only obesity was associated with FA use.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Fluorescence Angiography in Implant-Based Breast Reconstruction

et al. 2022

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“…Fluorescence-guided surgery is becoming increasingly utilized for perfusion assessment across many specialties, including in the management of colorectal cancer, with the next focus for field advance being cancer identification and delineation for intraoperative guidance [1][2][3][4][5][6]. New near infrared (NIR) fluorophores are in clinical trials for this purpose and potentially also for targeted cancer immunotherapy [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Geotemporal Fluorophore Biodistribution Mapping of Colorectal Cancer: Micro and Macroscopic Insights

Hardy,

Mulligan,

Dalli

et al. 2024

Current Oncology

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Fluorescence-guided oncology promises to improve both the detection and treatment of malignancy. We sought to investigate the temporal distribution of indocyanine green (ICG), an exogenous fluorophore in human colorectal cancer. This analysis aims to enhance our understanding of ICG’s effectiveness in current tumour detection and inform potential future diagnostic and therapeutic enhancements. Methods: Fifty consenting patients undergoing treatment for suspected/confirmed colorectal neoplasia provided near infrared (NIR) video and imagery of transanally recorded and ex vivo resected rectal lesions following intravenous ICG administration (0.25 mg/kg), with a subgroup providing tissue samples for microscopic (including near infrared) analysis. Computer vision techniques detailed macroscopic ‘early’ (<15 min post ICG administration) and ‘late’ (>2 h) tissue fluorescence appearances from surgical imagery with digital NIR scanning (Licor, Lincoln, NE, USA) and from microscopic analysis (Nikon, Tokyo, Japan) undertaken by a consultant pathologist detailing tissue-level fluorescence distribution over the same time. Results: Significant intra-tumoural fluorescence heterogeneity was seen ‘early’ in malignant versus benign lesions. In all ‘early’ samples, fluorescence was predominantly within the tissue stroma, with uptake within plasma cells, blood vessels and lymphatics, but not within malignant or healthy glands. At ‘late’ stage observation, fluorescence was visualised non-uniformly within the intracellular cytoplasm of malignant tissue but not retained in benign glands. Fluorescence also accumulated within any present peritumoural inflammatory tissue. Conclusion: This study demonstrates the time course diffusion patterns of ICG through both benign and malignant tumours in vivo in human patients at both macroscopic and microscopic levels, demonstrating important cellular drivers and features of geolocalisation and how they differ longitudinally after exposure to ICG.

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“…Infelizmente, é uma tecnologia cara e pouco disponível nos serviços de tratamento do câncer. 102 Outras complicações podem ocorrer, como infecção, seroma, hematoma, perda do implante ou do retalho autólogo e deiscência da sutura. 36 Para todas essas complicações, a radioterapia prévia também é considerada como fator agravante de risco.…”

Section: Complicações Pós-operatóriasunclassified

Adenectomia mamária para o tratamento do câncer de mama inicial: importância da avaliação da margem retroareolar e da remoção dos ductos intrapapilares

Heinzen¹

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

Cited by 12 publications

References 18 publications

Intraoperative Fluorescence Angiography in Implant-Based Breast Reconstruction

Intraoperative Fluorescence Angiography in Implant-Based Breast Reconstruction

Geotemporal Fluorophore Biodistribution Mapping of Colorectal Cancer: Micro and Macroscopic Insights

Adenectomia mamária para o tratamento do câncer de mama inicial: importância da avaliação da margem retroareolar e da remoção dos ductos intrapapilares

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