Laser-assisted indocyanine green angiography in implant-based immediate breast reconstruction: a retrospective study

Abstract

Objective: Necrosis in implant-based immediate breast reconstruction is a feared complication. Accurate evaluation of mastectomy skin flaps per-operatively is necessary to decrease this risk. The present study is the first in Scandinavia to review the effects of perioperative evaluation with laser-assisted indocyanine green fluorescence angiography (LA-ICGA).

Method: A retrospective review was performed using data from the electronic patient record at the Department of Plastic and Breast Surgery at Aarhus University Hospital in Denmark on all patients who underwent implant-based skin-sparing immediate breast reconstruction with ADM in the time period March 2012 to October 2015. A total of 92 patients undergoing 128 breasts reconstructions were included in the study. An evaluation of complications before and after the implementation of LA-ICGA was performed.

Results: No significant difference in necrosis rates requiring surgical revision (p = .411) or conservative treatment (p = .149) in patients undergoing implant-based immediate breast reconstruction were found.

Conclusion: Our results differ from previously published studies in that no beneficial effect on necrosis rates of was found after implementing LA-ICGA, possibly due to our limited sample size.

Keywords: Fluorescence angiography; SPY; acellular dermal matrix; breast reconstruction; indocyanine green; necrosis.