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ICG angiography in immediate and delayed autologous breast reconstructions: peroperative evaluation and postoperative outcomes

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@article{34f47aa508b240fea60e5a35bb893467,
title = "ICG angiography in immediate and delayed autologous breast reconstructions: peroperative evaluation and postoperative outcomes",
abstract = "Postoperative complications in patients undergoing autologous breast reconstruction should be kept at the lowest possible level. Optimization of autologous breast reconstruction, especially techniques that can identify tissue perfusion and ischemia, will greatly benefit the patients and consequently society. Hence, the aim of this study was to evaluate the complication rates for autologous pedicle flap breast reconstructions, with and without the use of ICG-angiography. A single-institution retrospective review of mastectomy patients was performed. A total of 230 cases who underwent immediate or delayed, unilateral or bilateral pedicle autologous flap breast reconstruction between January 2013 and September 2016 was reviewed. Complication rates in the ICG-angiography and clinical assessment group were evaluated and compared. A total of 191 cases were identified of which 77 were evaluated with ICG-angiography, and 114 were evaluated clinically. There was no significant difference in overall complication rates between the two groups (ICG-angiography, 36.4{\%}; Clinical assessment, 37.7{\%}; p = .88). No significant difference was observed when stratifying for major or minor complications. However, when stratifying for the timing of the reconstruction, the rate of major complications was significantly lower in the ICG-angiography group (ICG-angiography, 0{\%}; Clinical assessment 23.3{\%}; p = .039). BMI was significantly associated with increased risk of minor complications (p = .018), whereas there was no correlation to age, prior smoking, chemotherapy, radiation, diabetes, or hypertension. Our study found that use of ICG-angiography was associated with a significant decrease in the rate of major complications for immediate autologous reconstructions.",
keywords = "Angiography, Body Mass Index, Breast/blood supply, Breast Neoplasms/surgery, Coloring Agents, Female, Humans, Indocyanine Green, Intraoperative Care, Ischemia/prevention & control, Mammaplasty, Mastectomy, Middle Aged, Postoperative Complications, Retrospective Studies, Surgical Flaps/blood supply, Time-to-Treatment",
author = "Toke Alstrup and Christensen, {Bekka O} and Damsgaard, {Tine Engberg}",
year = "2018",
month = "10",
doi = "10.1080/2000656X.2018.1486320",
language = "English",
volume = "52",
pages = "307--311",
journal = "Journal of Plastic Surgery and Hand Surgery",
issn = "2000-656X",
publisher = "Informa Healthcare",
number = "5",

}

RIS

TY - JOUR

T1 - ICG angiography in immediate and delayed autologous breast reconstructions

T2 - peroperative evaluation and postoperative outcomes

AU - Alstrup, Toke

AU - Christensen, Bekka O

AU - Damsgaard, Tine Engberg

PY - 2018/10

Y1 - 2018/10

N2 - Postoperative complications in patients undergoing autologous breast reconstruction should be kept at the lowest possible level. Optimization of autologous breast reconstruction, especially techniques that can identify tissue perfusion and ischemia, will greatly benefit the patients and consequently society. Hence, the aim of this study was to evaluate the complication rates for autologous pedicle flap breast reconstructions, with and without the use of ICG-angiography. A single-institution retrospective review of mastectomy patients was performed. A total of 230 cases who underwent immediate or delayed, unilateral or bilateral pedicle autologous flap breast reconstruction between January 2013 and September 2016 was reviewed. Complication rates in the ICG-angiography and clinical assessment group were evaluated and compared. A total of 191 cases were identified of which 77 were evaluated with ICG-angiography, and 114 were evaluated clinically. There was no significant difference in overall complication rates between the two groups (ICG-angiography, 36.4%; Clinical assessment, 37.7%; p = .88). No significant difference was observed when stratifying for major or minor complications. However, when stratifying for the timing of the reconstruction, the rate of major complications was significantly lower in the ICG-angiography group (ICG-angiography, 0%; Clinical assessment 23.3%; p = .039). BMI was significantly associated with increased risk of minor complications (p = .018), whereas there was no correlation to age, prior smoking, chemotherapy, radiation, diabetes, or hypertension. Our study found that use of ICG-angiography was associated with a significant decrease in the rate of major complications for immediate autologous reconstructions.

AB - Postoperative complications in patients undergoing autologous breast reconstruction should be kept at the lowest possible level. Optimization of autologous breast reconstruction, especially techniques that can identify tissue perfusion and ischemia, will greatly benefit the patients and consequently society. Hence, the aim of this study was to evaluate the complication rates for autologous pedicle flap breast reconstructions, with and without the use of ICG-angiography. A single-institution retrospective review of mastectomy patients was performed. A total of 230 cases who underwent immediate or delayed, unilateral or bilateral pedicle autologous flap breast reconstruction between January 2013 and September 2016 was reviewed. Complication rates in the ICG-angiography and clinical assessment group were evaluated and compared. A total of 191 cases were identified of which 77 were evaluated with ICG-angiography, and 114 were evaluated clinically. There was no significant difference in overall complication rates between the two groups (ICG-angiography, 36.4%; Clinical assessment, 37.7%; p = .88). No significant difference was observed when stratifying for major or minor complications. However, when stratifying for the timing of the reconstruction, the rate of major complications was significantly lower in the ICG-angiography group (ICG-angiography, 0%; Clinical assessment 23.3%; p = .039). BMI was significantly associated with increased risk of minor complications (p = .018), whereas there was no correlation to age, prior smoking, chemotherapy, radiation, diabetes, or hypertension. Our study found that use of ICG-angiography was associated with a significant decrease in the rate of major complications for immediate autologous reconstructions.

KW - Angiography

KW - Body Mass Index

KW - Breast/blood supply

KW - Breast Neoplasms/surgery

KW - Coloring Agents

KW - Female

KW - Humans

KW - Indocyanine Green

KW - Intraoperative Care

KW - Ischemia/prevention & control

KW - Mammaplasty

KW - Mastectomy

KW - Middle Aged

KW - Postoperative Complications

KW - Retrospective Studies

KW - Surgical Flaps/blood supply

KW - Time-to-Treatment

U2 - 10.1080/2000656X.2018.1486320

DO - 10.1080/2000656X.2018.1486320

M3 - Journal article

VL - 52

SP - 307

EP - 311

JO - Journal of Plastic Surgery and Hand Surgery

JF - Journal of Plastic Surgery and Hand Surgery

SN - 2000-656X

IS - 5

ER -

ID: 59211098