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Table 6 Variables that may impact use of modalities to evaluate tissue perfusion

From: Intraoperative laser angiography using the SPY system: review of the literature and recommendations for use

Characteristics associated with ischemia Previous radiation treatment
Previous or aggressive surgery*
Current smoking
Obesity
Diabetes
Vasculopathy
Chronic corticosteroid use
Thin mastectomy flaps
Agents that interfere with imaging techniques Methylene blue
Lymphazurin blue
Agents that affect blood flow Vasoconstrictors (eg, epinephrine)**
  1. *Previous incisions may affect blood flow; ICG perfusion assessment may be of particular utility for detection of perfusion across scars.
  2. **Vasopressors affect all methods of estimation of perfusion in tissue. Diminished blood flow following administration of epinephrine may indicate the need to wait ≥2 hours for accurate ICG imaging. A negative result on ICG perfusion assessment may indicate the need to wait longer for recovery of perfusion.