Indocyanine green fluorescence angiography algorithm for determining additional anastomosis in deep inferior…

Cohort studyBreast cancer (Tokyo, Japan)· Aug 2026

Indocyanine green fluorescence angiography algorithm for determining additional anastomosis in deep inferior epigastric perforator flap for breast reconstruction.

Rie Hayasaka, Kenta Tanakura, Yukiko Kuramoto, Tomohiro Imai

Breast ReconstructionCohort studyTreatmentQ1IF 3.5

Additional anastomosis linked to higher deep inferior epigastric perforator flap utilization, 78.4% vs 53.5%.

Indocyanine green fluorescence angiography algorithm for determining additional anastomosis in deep inferior epigastric perforator flap for breast reconstruction.

Rie Hayasaka … Tomohiro Imai

Breast cancer (Tokyo, Japan) · Aug 2026 · Q1 in General Medicine

Background

Intraoperative indocyanine green (indocyanine green) fluorescence angiography (indocyanine green-FA) is commonly used to detect areas with poor perfusion.

Methods

Fifty patients who underwent unilateral breast reconstruction using a deep inferior epigastric perforator flap and intraoperative ICG-FA were included.

n = 50 patients

Results

Flap utilization averaged 78.4% with additional anastomosis vs 53.5% without, p < 0.001.

78.4%

AA group

53.5%

Non-AA group

More results

The probability of anastomosis increased significantly when the flap utilization rate was > 70%.

Seven types of anastomosis were identified.

The most common vessels used for anastomosis were the contralateral deep inferior epigastric artery and vein.

More results

Postoperatively, localized fat necrosis was observed in only one case (2%) in the anastomosis group.

“

Conclusion

Our ICG-FA algorithm was useful for minimizing the occurrence of fat necrosis and aiding the use of extensive deep inferior epigastric perforator flaps without complications, leading to better functional results for patients.

Indocyanine green fluorescence angiography algorithm for determining additional anastomosis in deep inferior epigastric perforator flap for breast reconstruction.

Indocyanine green fluorescence angiography algorithm for determining additional anastomosis in deep inferior epigastric perforator flap for breast reconstruction.

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