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European Archives of Oto-Rhino-Laryngology

06-09-2024 | Angiography | Head and Neck

Indocyanine green fluorescence video-angiography for flap perfusion assessment in head and neck reconstruction: a prospective study

Authors: Andrea Galli, Emilio Salerno, Chiara Bramati, Rosa Alessia Battista, Michela Nicole Melegatti, Elisa Dolfato, Gabriella Fusca, Carlo Pettirossi, Vittorio Gioffré, Marco Familiari, Diego Barbieri, Pietro Indelicato, Aurora Mirabile, Mario Bussi, Leone Giordano

Published in: European Archives of Oto-Rhino-Laryngology

Abstract

Purpose

Managing postoperative complications is crucial in reconstructive surgery. Indocyanine green fluorescence video-angiography (ICGA) aids in assessing flap vascularization intraoperatively, potentially reducing complications.

Methods

An ambispective study enrolled head and neck cancer patients undergoing ablative surgery with soft tissue reconstruction. An experimental arm (March 2021-May 2023) used ICGA, while a control arm (January 2017-December 2020) did not. Complications were graded by Clavien-Dindo classification. We also evaluated the effect of systemic inflammation on the sensitivity of ICGA in detecting hypoperfused areas of the flap.

Results

Complications were less frequent in the experimental arm, both overall (11.4% vs. 36.4%) and major ones (Clavien-Dindo ≥ 3) (8.6% vs. 30.9%). ICGA showed a protective effect in univariate and multivariate analyses. Previous radiation and ICGA were independent predictors of major complications. ICGA altered the surgical strategy in 25.7% of cases.

Conclusions

Real-time perfusion assessment, particularly with ICGA, can improve outcomes in head and neck cancer patients undergoing soft tissue reconstruction by reducing complications. Further research with larger cohorts is warranted for validation.

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Title: Indocyanine green fluorescence video-angiography for flap perfusion assessment in head and neck reconstruction: a prospective study
Authors: Andrea Galli
Emilio Salerno
Chiara Bramati
Rosa Alessia Battista
Michela Nicole Melegatti
Elisa Dolfato
Gabriella Fusca
Carlo Pettirossi
Vittorio Gioffré
Marco Familiari
Diego Barbieri
Pietro Indelicato
Aurora Mirabile
Mario Bussi
Leone Giordano
Publication date: 06-09-2024
Publisher: Springer Berlin Heidelberg
Keyword: Angiography
Published in: European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08959-5

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Indocyanine green fluorescence video-angiography for flap perfusion assessment in head and neck reconstruction: a prospective study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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