Related Experiment Video
Updated: Jun 14, 2025
Fluorescence Angiography for Evaluation of Aneurysm Perfusion and Parent Artery Patency in Rat and Rabbit Aneurysm Models
Published on: July 24, 2019
Indocyanine green fluorescence video-angiography for flap perfusion assessment in head and neck reconstruction: a
Andrea Galli1,2, Emilio Salerno3, Chiara Bramati4
1Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, 20132, Italy. agalli89@gmail.com.
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.
