The Role of Indocyanine Green Angiography in Breast Reconstruction

Although mastectomy skin flap necrosis is a common complication after breast reconstruction, current methods for assessing the likelihood of necrosis rely almost exclusively on clinician judgment. Indocyanine green (ICG) angiography is a technology, however, that uses near-infrared imaging to visualize perfusion in superficial tissues in real time. In breast reconstruction, studies have shown that ICG angiography independently predicts post-operative outcomes and, when used in conjunction with clinical judgment, decreases rates of mastectomy skin flap necrosis. The goal of this chapter is to introduce the technology of ICG angiography and provide an overview from the recent literature of how the technology can be instrumental in predicting post-operative complications after breast reconstruction.