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Fluorescent Angiography for Flap Planning and Monitoring in Reconstructive Surgery

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Fluorescence Imaging for Surgeons

Abstract

Reconstructive surgery has for objective to restore anatomical defects using flaps. We tested fluorescent angiography in reconstructive surgery using the Fluobeam™ device for flap planning and monitoring. A cadaveric study allowed validating the ergonomics to transfer this technology for clinical trials. A clinical study validated the relevance of fluorescent angiography for perforator flap planning. We compared it with the surgical dissection and with routine investigation. The same technology was also used for flap monitoring. Fluorescent angiography clearly identified flap complication (thrombosis) earlier than clinical assessment. Fluorescent angiography seems to be a good tool for flap planning and monitoring.

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Disclosure: The clinical trial mentioned in this article was supported by a grant from GRAVIT-innovation (Grenoble-Alpes) and the Grenoble University Hospital clinical research management.

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Correspondence to Georges Bettega M.D. Ph.D. .

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Video 32.1

Visualization of fluorescent spots on the lateral side of the leg, after ICG injection to map perforator vessels of a right fibular flap (AVI 630 kb)

Video 32.2

Mapping of the perforator vessels in a fibular flap using a fluorescent ruler to improve accuracy (WMV 1,786 kb)

Video 32.3

Per-operative fluorescent angiography of a fibular flap. The fibular artery is illuminated on the center on the image first; the skin paddle is then illuminated on the right side; and last, the vein is illuminated on the left side of the artery (AVI 778 kb)

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Bettega, G. et al. (2015). Fluorescent Angiography for Flap Planning and Monitoring in Reconstructive Surgery. In: Dip, F., Ishizawa, T., Kokudo, N., Rosenthal, R. (eds) Fluorescence Imaging for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-15678-1_32

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  • DOI: https://doi.org/10.1007/978-3-319-15678-1_32

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15677-4

  • Online ISBN: 978-3-319-15678-1

  • eBook Packages: MedicineMedicine (R0)

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