Lecture by Dr. med. Zeynep Altayli
Indocyanine green (ICG) and its use in daily medical practice
Plastische Chirurgie Frankfurt | Hochtaunus
Introduction:
Indocyanine green (ICG) is a fluorescent dye that has been used in medical diagnostics for over 50 years. With video fluoroscopy, it is used in various medical specialties to assess perfusion and angiography. Indocyanine green is also used daily in plastic and reconstructive surgery.
Fields of application for ICG:
- Sentinel lymph node biopsy„
In addition to the technique of „sentinel lymph node biopsy“ using blue dye (isosulfan blue, methylene blue) and radiolabeled colloid (99mTechnetium), which are associated either with anaphylactic reactions and false-negative detection rates or significant logistical effort due to the radioactive substance, ICG video-fluoroscopy represents an important alternative. Taking into account the advantages and disadvantages of the established methods, ICG video-fluoroscopy with simple in-situ visualization in real-time technology can detect sentinel lymph nodes and lymphatic channels more cost-effectively and with significantly lower side effects.
– „Flap / tissue perfusion“
In plastic and reconstructive surgery, ICG video-fluoroscopy is an established method for assessing flap and tissue perfusion. In microsurgical procedures, anastomotic patency and flap blood flow can be assessed in real time. This can reduce revision procedures and flap necrosis.
-Lympho-Fluoroscopy„
In our practice, we use ICG as a minimally invasive method for visualizing lymphatic vessels and evaluating lymphedemas. Especially in secondary lymphedemas, „lymphofluoroscopy“ shows us the interruption of the lymphatic vessels and the stasis of lymph, allowing us to adapt the surgical therapy. With the help of „reverse mapping“ using „lymphofluoroscopy“
can the complication of iatrogenic lymphedema after free microsurgical lymph node transfer be reduced.
Summary:
ICG video-fluoroscopy is a procedure that is easy to use in clinical routine for the temporal and spatial visualization of the microcirculation and the lymphatic system with a low risk profile.
http://www.lymphologicum.de/images/CAMPUS2016/Programm_Campus__2016.pdf
Learn more: Surgical lymphedema treatment in Frankfurt · Dr. med. Zeynep Potente