Sensitivity and Specificity of ICG Angiography in Free Flap Reexploration
Sensitivity and Specificity of ICG Angiography in Free Flap Reexploration
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DOI：
10.1055/s-0030-1249314
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发表时间：
2010-07-01
影响因子：
2.1
通讯作者：
Ninkovic, Milomir
中科院分区：
文献类型：
--
作者：
Holm, Charlotte;Dornseifer, Ulf;Ninkovic, Milomir
显微镜集成吲哚菁绿近红外视频血管造影（ICGA）是一种用于评估微血管手术中微小血管血流的新型成像技术。本研究的目的是评估ICGA在再次探查手术中检测微血管血栓的诊断准确性。本临床研究纳入了游离组织移植后接受紧急再次探查手术的患者。患者被送回手术室后，暴露蒂部血管并进行微血管造影。无论结果如何，均打开吻合口并进行手术探查。以探查手术的结果作为参考标准计算敏感度和特异度。在200个游离皮瓣中，20个（10%）接受了再次探查手术。最常见的手术发现是微血管血栓（55%）。有1例血管受损是由于动脉和静脉混淆，吻合了两条静脉。40%的患者发现血管蒂完整。ICGA检测微血管血栓的敏感度和特异度分别为100%和86%。ICGA在再次探查手术中对检测微血管血栓具有极高的诊断准确性。常规应用该技术可加快正确诊断，并通过避免对完整吻合口进行不必要的手术操作来简化手术方式。
Microscope-integrated indocyanine green near-infrared videoangiography (ICGA) is a new imaging technique to assess vascular flow through diminutive vessels used in microvascular surgery. The purpose of this investigation was to evaluate the diagnostic accuracy of ICGA in detecting microvascular thrombosis in reexploration surgery. Patients undergoing emergent reexploration surgery after free tissue transfer were enrolled in this clinical study. After the patients had been returned to the operating room the pedicle vessels were exposed and a microangiography was performed. Independent of the result, the anastomoses were opened and surgically explored. Sensitivity and specificity was calculated, using the result of exploration surgery as a reference standard. Of 200 free flaps 20 (10%) underwent reexploration surgery. The most common surgical finding was microvascular thrombosis (55%). In one case vascular compromise was due to confusion of artery and vein with anastomosis of two veins. In 40% of patients an intact vascular pedicle was found. The sensitivity and specificity of ICGA to detect microvascular thrombosis was 100% and 86%, respectively. ICGA provides an excellent diagnostic accuracy for detecting microvascular thrombosis in reexploration surgery. Routine implementation of this technique may expedite a correct diagnosis and facilitate the surgical approach by preventing unnecessary surgical manipulation of intact anastomoses.