Intraoperative laser angiography using the SPY system: Review of the literature and recommendations for use

Annals of Surgical Innovation and Research

Volumn 7, Issue 1, 2013, Pages

  Gurtner, Geoffrey C ^a   Jones, Glyn E ^b   Neligan, Peter C ^c   Newman, Martin I ^d   Phillips, Brett T ^e   Sacks, Justin M ^f   Zenn, Michael R ^g  

^a STANFORD UNIVERSITY MEDICAL CENTER   (United States)

^b Peoria Surgical Group   (United States)

^c UNIVERSITY OF WASHINGTON MEDICAL CENTER   (United States)

^d DEPARTMENT OF COLORECTAL SURGERY   (United States)

^e STONY BROOK UNIVERSITY MEDICAL CENTER   (United States)

^f JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^g DUKE UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

Flap; Indocyanine green; Laser angiography; Microsurgery; Near infrared; Necrosis; Perfusion assessment; Reconstructive surgery; SPY

Indexed keywords

EID: 84871860032     PISSN: None     EISSN: 17501164     Source Type: Journal    
DOI: 10.1186/1750-1164-7-1     Document Type: Review

References (70)

1. Komorowska-Timek E, Gurtner GC. Intraoperative perfusion mapping with laser-assisted indocyanine green imaging can predict and prevent complications in immediate breast reconstruction. Plast Reconstr Surg 2010, 125:1065-1073.
2. Kubo T, Yano K, Hosokawa K. Management of flaps with compromised venous outflow in head and neck microsurgical reconstruction. Microsurgery 2002, 22:391-395.
3. Garvey PB, Buchel EW, Pockaj BA, Casey W, Gray RJ, Hernandez JL, Samson TD. DIEP and pedicled TRAM flaps: a comparison of outcomes. Plast Reconstr Surg 2006, 117:1711-1719.
4. Spear SL, Ducic I, Cuoco F, Hannan C. The effect of smoking on flap and donor-site complications in pedicled TRAM breast reconstruction. Plast Reconstr Surg 2005, 116:1873-1880.
5. Pestana IA, Coan B, Erdmann D, Marcus J, Levin LS, Zenn MR. Early experience with fluorescent angiography in free-tissue transfer reconstruction. Plast Reconstr Surg 2009, 123:1239-1244.
6. Newman MI, Samson MC, Tamburrino JF, Swartz KA, Brunworth L. An investigation of the application of laser-assisted indocyanine green fluorescent dye angiography in pedicle transverse rectus abdominus myocutaneous breast reconstruction. Can J Plast Surg 2011, 19:e1-e5.
7. Jallali N, Ridha H, Butler PE. Postoperative monitoring of free flaps in UK plastic surgery units. Microsurgery 2005, 25:469-472.
8. Mothes H, Donicke T, Friedel R, Simon M, Markgraf E, Bach O. Indocyanine-green fluorescence video angiography used clinically to evaluate tissue perfusion in microsurgery. J Trauma 2004, 57:1018-1024.
9. Olivier WA, Hazen A, Levine JP, Soltanian H, Chung S, Gurtner GC. Reliable assessment of skin flap viability using orthogonal polarization imaging. Plast Reconstr Surg 2003, 112:547-555.
10. Tan BK, Newman MI, Swartz KA, Samson MC. Subfascial perforator dissection for DIEP flap harvest. Plast Reconstr Surg 2009, 124:1001-1002.
11. Newman MI, Samson MC. The application of laser-assisted indocyanine green fluorescent dye angiography in microsurgical breast reconstruction. J Reconstr Microsurg 2009, 25:21-26.
12. Phillips BT, Lanier ST, Conkling N, Wang ED, Dagum AB, Ganz JC, Khan SU, Bui DT. Intraoperative perfusion techniques can accurately predict mastectomy skin flap necrosis in breast reconstruction: results of a prospective trial. Plast Reconstr Surg 2012, 129:778e-788e.
13. Giunta RE, Holzbach T, Taskov C, Holm PS, Brill T, Busch R, Gansbacher B, Biemer E. Prediction of flap necrosis with laser induced indocyanine green fluorescence in a rat model. Br J Plast Surg 2005, 58:695-701.
14. Jones GE, Garcia CA, Murray J, Elwood ET, Whitty LA. Fluorescent intraoperative tissue angiography for the evaluation of the viability of pedicled TRAM flaps. Plast Reconstr Surg 2009, 124:53.
15. Elite System SPY. Kit instructions for use 2011, Branchburg, NJ: LifeCell Corp.
16. Murray JD, Jones GE, Elwood ET, Whitty LA, Garcia C. Fluorescent intraoperative tissue angiography with indocyanine green: evaluation of nipple-areola vascularity during breast reduction surgery. Plast Reconstr Surg 2010, 126:33e-34e.
17. Tamburrino JF, Newman MI, Samson MC, Swartz KA. Laser-assisted indocyanine green fluorescent dye angiography (LA-ICG) in evaluation of mastectomy flaps 2010, Florida: Boca Raton, Presented at: 2010 annual meeting for AAHS, ASPN, and ASRM.
18. Azuma R, Morimoto Y, Masumoto K, Nambu M, Takikawa M, Yanagibayashi S, Yamamoto N, Kikuchi M, Kiyosawa T. Detection of skin perforators by indocyanine green fluorescence nearly infrared angiography. Plast Reconstr Surg 2008, 122:1062-1067.
19. Prantl L, Schmitt S, Gais S, Tsui TY, Lamby P, Babilas P, Nerlich M, Kubale R, Zorger N, Herold T, et al. Contrast harmonic ultrasound and indocyanine-green fluorescence video angiography for evaluation of dermal and subdermal microcirculation in free parascapular flaps. Clin Hemorheol Microcirc 2008, 38:31-44.
20. De Lorenzi F, Yamaguchi S, Petit JY, Rietjens M, Garusi C, Martella S, Rey PC, Gennari R. Evaluation of skin perfusion after nipple-sparing mastectomy by indocyanine green dye. Preliminary results. J Exp Clin Cancer Res 2005, 24:347-354.
21. Holm C, Tegeler J, Mayr M, Becker A, Pfeiffer UJ, Muhlbauer W. Monitoring free flaps using laser-induced fluorescence of indocyanine green: a preliminary experience. Microsurgery 2002, 22:278-287.
22. Holm C, Mayr M, Hofter E, Becker A, Pfeiffer UJ, Muhlbauer W. Intraoperative evaluation of skin-flap viability using laser-induced fluorescence of indocyanine green. Br J Plast Surg 2002, 55:635-644.
23. Still J, Law E, Dawson J, Bracci S, Island T, Holtz J. Evaluation of the circulation of reconstructive flaps using laser-induced fluorescence of indocyanine green. Ann Plast Surg 1999, 42:266-274.
24. Rozen WM, Phillips TJ, Ashton MW, Stella DL, Gibson RN, Taylor GI. Preoperative imaging for DIEA perforator flaps: a comparative study of computed tomographic angiography and doppler ultrasound. Plast Reconstr Surg 2008, 121:1-8.
25. Khalid AN, Quraishi SA, Zang WA, Chadwick JL, Stack BCJ. Color doppler ultrasonography is a reliable predictor of free tissue transfer outcomes in head and neck reconstruction. Otolaryng Head Neck 2006, 134:635-638.
26. Giunta RE, Geisweid A, Feller AM. The value of preoperative Doppler sonography for planning free perforator flaps. Plast Reconstr Surg 2000, 105:2381-2386.
27. Hallock GG. Doppler sonography and color duplex imaging for planning a perforator flap. Clin Plast Surg 2003, 30:347-357.
28. Blondeel PN, Beyens G, Verhaeghe R, Van Landuyt K, Tonnard P, Monstrey SJ, Matton G. Doppler flowmetry in the planning of perforator flaps. Br J Plast Surg 1998, 51:202-209.
29. Yu P, Youssef A. Efficacy of the handheld Doppler in preoperative identification of the cutaneous perforators in the anterolateral thigh flap. Plast Reconstr Surg 2006, 118:928-933. discussion 934-925.
30. Schlosser S, Wirth R, Plock JA, Serov A, Banic A, Erni D. Application of a new laser Doppler imaging system in planning and monitoring of surgical flaps. J Biomed Opt 2010, 15:036023.
31. Holzle F, Loeffelbein DJ, Nolte D, Wolff KD. Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry. J Craniomaxillofac Surg 2006, 34:25-33.
32. Heller L, Levin LS, Klitzman B. Laser Doppler flowmeter monitoring of free-tissue transfers: blood flow in normal and complicated cases. Plast Reconstr Surg 2001, 107:1739-1745.
33. Heden P, Jurell G, Arnander C. Prediction of skin flap necrosis: a comparative study between laser Doppler flowmetry and fluorescein test in a rat model. Ann Plast Surg 1986, 17:485-488.
34. Ghattaura A, Henton J, Jallali N, Rajapakse Y, Savidge C, Allen S, Searle AE, Harris PA, James SE. One hundred cases of abdominal-based free flaps in breast reconstruction. The impact of preoperative computed tomographic angiography. JPRAS 2010, 63:1597-1601.
35. Smit JM, Dimopoulou A, Liss AG, Zeebregts CJ, Kildal M, Whitaker IS, Magnusson A, Acosta R. Preoperative CT angiography reduces surgery time in perforator flap reconstruction. JPRAS 2009, 62:1112-1117.
36. Cina A, Salgarello M, Barone-Adesi L, Rinaldi P, Bonomo L. Planning breast reconstruction with deep inferior epigastric artery perforating vessels: multidetector CT angiography versus color Doppler US. Radiology 2010, 255:979-987.
37. Scott JR, Liu D, Said H, Neligan PC, Mathes DW. Computed tomographic angiography in planning abdomen-based microsurgical breast reconstruction: a comparison with color duplex ultrasound. Plast Reconstr Surg 2010, 125:446-453.
38. Phillips TJ, Stella DL, Rozen WM, Ashton M, Taylor GI. Abdominal wall CT angiography: a detailed account of a newly established preoperative imaging technique. Radiology 2008, 249:32-44.
39. Rosson GD, Williams CG, Fishman EK, Singh NK. 3D CT angiography of abdominal wall vascular perforators to plan DIEAP flaps. Microsurgery 2007, 27:641-646.
40. Masia J, Clavero JA, Larranaga JR, Alomar X, Pons G, Serret P. Multidetector-row computed tomography in the planning of abdominal perforator flaps. JPRAS 2006, 59:594-599.
41. Chernyak V, Rozenblit AM, Greenspun DT, Levine JL, Milikow DL, Chia FA, Erhard HA. Breast reconstruction with deep inferior epigastric artery perforator flap: 3.0-T gadolinium-enhanced MR imaging for preoperative localization of abdominal wall perforators. Radiology 2009, 250:417-424.
42. Schaverien MV, Ludman CN, Neil-Dwyer J, Perks GB, Akhtar N, Rodrigues JN, Benetatos K, Raurell A, Rasheed T, McCulley SJ. Contrast-enhanced magnetic resonance angiography for preoperative imaging in DIEP flap breast reconstruction. Plast Reconstr Surg 2011, 128:56-62.
43. Newman TM, Vasile J, Levine JL, Greenspun DT, Allen RJ, Chao MT, Winchester PA, Prince MR. Perforator flap magnetic resonance angiography for reconstructive breast surgery: a review of 25 deep inferior epigastric and gluteal perforator artery flap patients. J Magn Reson Imaging 2010, 31:1176-1184.
44. Neil-Dwyer JG, Ludman CN, Schaverien M, McCulley SJ, Perks AG. Magnetic resonance angiography in preoperative planning of deep inferior epigastric artery perforator flaps. JPRAS 2009, 62:1661-1665.
45. Greenspun D, Vasile J, Levine JL, Erhard H, Studinger R, Chernyak V, Newman T, Prince M, Allen RJ. Anatomic imaging of abdominal perforator flaps without ionizing radiation: seeing is believing with magnetic resonance imaging angiography. J Reconstruc Microsurgery 2010, 26:37-44.
46. Rozen WM, Stella DL, Bowden J, Taylor GI, Ashton MW. Advances in the pre-operative planning of deep inferior epigastric artery perforator flaps: magnetic resonance angiography. Microsurgery 2009, 29:119-123.
47. Steele MH. Three-year experience using near infrared spectroscopy tissue oximetry monitoring of free tissue transfers. Ann Plast Surg 2011, 66:540-545.
48. Lin SJ, Nguyen MD, Chen C, Colakoglu S, Curtis MS, Tobias AM, Lee BT. Tissue oximetry monitoring in microsurgical breast reconstruction decreases flap loss and improves rate of flap salvage. Plast Reconstr Surg 2011, 127:1080-1085.
49. Keller A. A new diagnostic algorithm for early prediction of vascular compromise in 208 microsurgical flaps using tissue oxygen saturation measurements. Ann Plast Surg 2009, 62:538-543.
50. Keller A. Noninvasive tissue oximetry for flap monitoring: an initial study. J Reconstr Microsurg 2007, 23:189-197.
51. Losken A, Styblo TM, Schaefer TG, Carlson GW. The use of fluorescein dye as a predictor of mastectomy skin flap viability following autologous tissue reconstruction. Ann Plast Surg 2008, 61:24-29.
52. Francisco BS, Kerr-Valentic MA, Agarwal JP. Laser-assisted indocyanine green angiography and DIEP breast reconstruction. Plast Reconstr Surg 2010, 125:116e-118e.
53. Rubben A, Eren S, Krein R, Younossi H, Bohler U, Wienert V. Infrared videoangiofluorography of the skin with indocyanine green-rat random cutaneous flap model and results in man. Microvasc Res 1994, 47:240-251.
54. Singer R, Lewis CM, Franklin JD, Lynch JB. Fluorescein test for prediction of flap viability during breast reconstructions. Plast Reconstr Surg 1978, 61:371-375.
55. Jones BM. Monitors for the cutaneous microcirculation. Plast Reconstr Surg 1984, 73:843-850.
56. May JWJ, Chait LA, O'Brien BM, Hurley JV. The no-reflow phenomenon in experimental free flaps. Plast Reconstr Surg 1978, 61:256-267.
57. Flower RW, Hochheimer BF. A clinical technique and apparatus for simultaneous angiography of the separate retinal and choroidal circulations. Invest Ophthalmol 1973, 12:248-261.
58. Dzurinko VL, Gurwood AS, Price JR. Intravenous and indocyanine green angiography. Optometry 2004, 75:743-755.
59. Desai ND, Miwa S, Kodama D, Koyama T, Cohen G, Pelletier MP, Cohen EA, Christakis GT, Goldman BS, Fremes SE. A randomized comparison of intraoperative indocyanine green angiography and transit-time flow measurement to detect technical errors in coronary bypass grafts. J Thorac Cardiovasc Surg 2006, 132:585-594.
60. Reuthebuch O, Haussler A, Genoni M, Tavakoli R, Odavic D, Kadner A, Turina M. Novadaq SPY: intraoperative quality assessment in off-pump coronary artery bypass grafting. Chest 2004, 125:418-424.
61. Kang Y, Lee J, Kwon K, Choi C. Dynamic fluorescence imaging of indocyanine green for reliable and sensitive diagnosis of peripheral vascular insufficiency. Microvasc Res 2010, 80:552-555.
62. Kang Y, Lee J, Kwon K, Choi C. Application of novel dynamic optical imaging for evaluation of peripheral tissue perfusion. Int J Cardiol 2010, 145:e99-e101.
63. Sekijima M, Tojimbara T, Sato S, Nakamura M, Kawase T, Kai K, Urashima Y, Nakajima I, Fuchinoue S, Teraoka S. An intraoperative fluorescent imaging system in organ transplantation. Transplant Proc 2004, 36:2188-2190.
64. Eren S, Rubben A, Krein R, Larkin G, Hettich R. Assessment of microcirculation of an axial skin flap using indocyanine green fluorescence angiography. Plast Reconstr Surg 1995, 96:1636-1649.
65. Matsui A, Lee BT, Winer JH, Laurence RG, Frangioni JV. Predictive capability of near-infrared fluorescence angiography in submental perforator flap survival. Plast Reconstr Surg 2010, 126:1518-1527.
66. Matsui A, Lee BT, Winer JH, Laurence RG, Frangioni JV. Quantitative assessment of perfusion and vascular compromise in perforator flaps using a near-infrared fluorescence-guided imaging system. Plast Reconstr Surg 2009, 124:451-460.
67. Yamaguchi S, De Lorenzi F, Petit JY, Rietjens M, Garusi C, Giraldo A, Rey PC, Urban C, Martella S, Bosco R. The " perfusion map" of the unipedicled TRAM flap to reduce postoperative partial necrosis. Ann Plast Surg 2004, 53:205-209.
68. Graham BH, Walton RL, Elings VB, Lewis FR. Surface quantification of injected fluorescein as a predictor of flap viability. Plast Reconstr Surg 1983, 71:826-833.
69. Benya R, Quintana J, Brundage B. Adverse reactions to indocyanine green: a case report and a review of the literature. Cathet Cardiovasc Diagn 1989, 17:231-233.
70. Hope-Ross M, Yannuzzi LA, Gragoudas ES, Guyer DR, Slakter JS, Sorenson JA, Krupsky S, Orlock DA, Puliafito CA. Adverse reactions due to indocyanine green. Ophthalmology 1994, 101:529-533.