Indocyanine green angiography and the old question of vascular autonomy - Long term changes of microcirculation in microsurgically transplanted free flaps.
Vascular autonomization
free flaps
indocyanine green angiography
microcirculation
Journal
Clinical hemorheology and microcirculation
ISSN: 1875-8622
Titre abrégé: Clin Hemorheol Microcirc
Pays: Netherlands
ID NLM: 9709206
Informations de publication
Date de publication:
2019
2019
Historique:
pubmed:
23
4
2019
medline:
20
12
2019
entrez:
23
4
2019
Statut:
ppublish
Résumé
Free tissue transfer has become a routine procedure with low failure. In case of a compromised vascular pedicle, flap survival is time dependantly possible due to flap autonomization. However it remains unknown at what time and to which degree different factors influence flap autonomization. We investigated 16 patients after free flap reconstruction at different anatomic locations who eventually presented for other medical reasons. To assess the perfusion pattern we performed Indocyanine Green angiography. The mean follow-up after free flap reconstruction was 58,1 month. A total of 16 flaps were examined at different anatomic locations. In 2 cases digital subtraction angiography demonstrated an occlusion of the anastomosis after arteriovenous loop despite vital flaps. Indocyanine Green angiography showed no signs of mal-perfusion or non-perfusion in the transplanted flaps and capillaries across the flap borders in 9 cases. Flap autonomization is possible even in patients with problem wounds and poorly vascularized wound beds independent from the anatomic localization. Multiple factors exist, that influence the autonomization process over time. Indocyanine Green angiography seems to be a promising tool to visualize and study the skin perfusion pattern of free flaps over longer periods.
Sections du résumé
BACKGROUND
BACKGROUND
Free tissue transfer has become a routine procedure with low failure. In case of a compromised vascular pedicle, flap survival is time dependantly possible due to flap autonomization. However it remains unknown at what time and to which degree different factors influence flap autonomization.
METHODS
METHODS
We investigated 16 patients after free flap reconstruction at different anatomic locations who eventually presented for other medical reasons. To assess the perfusion pattern we performed Indocyanine Green angiography.
RESULTS
RESULTS
The mean follow-up after free flap reconstruction was 58,1 month. A total of 16 flaps were examined at different anatomic locations. In 2 cases digital subtraction angiography demonstrated an occlusion of the anastomosis after arteriovenous loop despite vital flaps. Indocyanine Green angiography showed no signs of mal-perfusion or non-perfusion in the transplanted flaps and capillaries across the flap borders in 9 cases.
CONCLUSION
CONCLUSIONS
Flap autonomization is possible even in patients with problem wounds and poorly vascularized wound beds independent from the anatomic localization. Multiple factors exist, that influence the autonomization process over time. Indocyanine Green angiography seems to be a promising tool to visualize and study the skin perfusion pattern of free flaps over longer periods.
Identifiants
pubmed: 31006673
pii: CH180544
doi: 10.3233/CH-180544
doi:
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM