CC BY-NC-ND 4.0 · Laryngorhinootologie 2021; 100(S 02): S32
DOI: 10.1055/s-0041-1727681
Abstracts
Surgical assistance procedures

Using ICG fluorescent angiography to monitor anastomoses in head and neck surgery

D Voggetzer
1   Universitätsklinikum Augsburg, Hno, Augsburg
,
T Strenger
1   Universitätsklinikum Augsburg, Hno, Augsburg
,
J Zenk
1   Universitätsklinikum Augsburg, Hno, Augsburg
,
M Mayer
1   Universitätsklinikum Augsburg, Hno, Augsburg
› Author Affiliations
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    Introduction ICG fluorescent angiography is gradually gaining importance in the field of free microvascular flap surgery. This study focuses on the anastomose and the hemodynamics of the flap pedicle as keypoint for free flap survival and examines the intrapoerative detection of anastomose deficiency and the importance of pedicle hemodynamics regarding flap survival.

    Material und Methods During 2/2019 to 9/2020 23 patients with head and neck cancer undergoing surgery with free microvascular flaps were included in this study (21 radial forearm, 1 ALT, 1 pectoralis major). After anastomosis of the pedicle ICG fluorescent angiography was performes. The results of blood flow and hemodynamics ((internal transit time, full volume time) in the pedicle were correlated with free flap necrosis. ICG fluorescent angiography and surgery was performed with the Zeiss Kinevo 900 microscope, the modes Flow 800 and Infrared 800 were used for measurement.

    Results There was no case of flap necrosis. In four cases (17,4 % ) occlusion of the anastomose (one venous, three arterial) could be detected and revised intraoperatively. In one case (4,3 % ) leakage of the anastomose was not detected until fluorescent angiography. Measurement regarding pedicle bloodflow and hemodynamics showed strong variability and had no influence on flap survival. There was no case of allergy or side-effect during or after ICG administration.

    Discussion From our experience, intraoperative ICG fluorescent angiography is a effective tool for the evaluation of microvascular anastomoses in free flap surgery in head and neck cancer. It is both effective and safe and has been established as standard procedure in our clinic.

    Poster-PDF A-1477.pdf

    ZEISS


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    Conflict of interest

    The first author points out the following conflict of interest: Zeiss (kostenlose Bereitstellung der kostenpflichtigen Filtermodi Flow 800 und Infrared 800.

    Address for correspondence

    Voggetzer Daniel
    Universitätsklinikum Augsburg, Hno
    Augsburg

    Publication History

    Article published online:
    13 May 2021

    © 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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