title: Dynamic blood flow to the retrograde limb of the internal mammary vein in breast reconstruction with free flap.
abstract: BACKGROUND
  In free flap breast reconstruction, the retrograde limb of the internal mammary vein (IMV) is occasionally used as a second recipient vein. In this study, we evaluated the dynamic blood flow to the retrograde limb of the IMV (retrograde IMV) at the anastomosed site via indocyanine green (ICG) angiography
  
  
  METHODS
  In 40 patients undergoing free flap breast reconstruction, we evaluated the dynamic blood flow as "stain(+)" if a stain by ICG was observed and, "flow(+)" if a smooth blood flow was recognized.
  
  
  RESULTS
  Based on the ICG angiography, "stain(+)" was observed in all cases, but "flow(+)" was detected in only 72.5% of the cases. There was no severe complication.
  
  
  CONCLUSIONS
  This study shows that thrombosis is prone to occur in the second recipient vein in the 27.5% of the cases with no smooth flow, and therefore, the retrograde IMV may not function as a back-up in these cases.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Sugawara
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Satake
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Muto
authors.affiliation: KO CLINIC For Antiaging, Yokohama, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Kou
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yasumura
authors.affiliation: Department of Plastic and Reconstructive Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Maegawa
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001940:Breast / Q000098:blood supply*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis; D012039:Regional Blood Flow; D012189:Retrospective Studies; D014680:Veins / Q000502:physiology* / Q000601:surgery; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology*