Affiliations: [a] Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Correspondence:
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Corresponding authors: Armin Edalatpour, Division of Plastic and Reconstructive Surgery, 600 Highland Ave. G5/360, Madison, WI 53792, USA. E-mail: edalatpour@surgery.wisc.edu. Ahmed M. Afifi, Division of Plastic and Reconstructive Surgery, 600 Highland Ave. CSC G5/361, Madison, WI 53792, USA. Tel.: +1 608 265 2535; Fax: +1 608 265 9695; E-mail: afifi@surgery.wisc.edu
Abstract: Intraoperative vascular imaging using indocyanine green (ICG) angiography may better predict flap viability than clinical judgement alone. Intraoperative ICG angiography was used in a chronic corticosteroid user undergoing bilateral nipple sparing mastectomy with expander placement. Large blood vessels were visualized, however, the skin surrounding these vessels remained dark. The flap demarcated to full-thickness necrosis that matched the intraoperative SPY findings. Visualization of intact blood vessels may not be sufficient to rule out flap necrosis in some patients. In these circumstances, interpretation of perfusion with consideration of patient factors will be required to accurately predict flap viability.
Keywords: ICG, microangiopathy, mastectomy skin flap, breast reconstruction
DOI: 10.3233/BD-201050
Journal: Breast Disease, vol. 40, no. 2, pp. 115-116, 2021
