J Reconstr Microsurg 2010; 26(1): 059-065
DOI: 10.1055/s-0029-1244805
© Thieme Medical Publishers

Intraoperative Near-infrared Fluorescence Imaging in Perforator Flap Reconstruction: Current Research and Early Clinical Experience

Bernard T. Lee1 , Aya Matsui2 , 5 , Merlijn Hutteman2 , Samuel J. Lin1 , Joshua H. Winer4 , Rita G. Laurence2 , John V. Frangioni2 , 3
  • 1Division of Plastic and Reconstructive Surgery, Boston, Massachusetts
  • 2Division of Hematology/Oncology, Boston, Massachusetts
  • 3Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 4Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
  • 5Division of Cancer Diagnostics and Therapeutics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Further Information

Publication History

Publication Date:
21 December 2009 (online)

ABSTRACT

Despite recent advances in perforator flap reconstruction, there can be significant variability in vessel size and location. Although preoperative evaluation may provide valuable information, real-time intraoperative methods have the potential to provide the greatest benefit. Our laboratory has developed the Fluorescence-Assisted Resection and Exploration (FLARE™) near-infrared (NIR) fluorescence imaging system for intraoperative visualization of details of the underlying vasculature. The FLARE™ system uses indocyanine green, a safe and reliable NIR fluorophore already FDA-approved for other indications. The system has been optimized in large-animal models for the identification of perforator size, location, and perfusion and has also been translated to the clinic for use during breast reconstruction after mastectomy. In this article, we review our preclinical and clinical data, as well as literature describing the use of similar NIR fluorescence imaging systems in plastic and reconstructive surgery.

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John V FrangioniM.D. Ph.D. 

B.I.D.M.C., Room SL-B05

330 Brookline Avenue, Boston, MA 02215

Email: jfrangio@bidmc.harvard.edu