Indocyanine green fluorescence angiography for free flap monitoring: A pilot study

2016 ◽  
Vol 44 (11) ◽  
pp. 1833-1841 ◽  
Author(s):  
Marine Hitier ◽  
Jean-Luc Cracowski ◽  
Cynthia Hamou ◽  
Christian Righini ◽  
Georges Bettega
Keyword(s):  
Pilot Study ◽  
Indocyanine Green ◽  
Free Flap ◽  
Fluorescence Angiography ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Free Flap Monitoring ◽  
Flap Monitoring ◽  
Indocyanine Green Fluorescence Angiography

Pilot study using intraoperative fluorescence angiography during arteriovenous hemodialysis access surgery

2018 ◽  
Vol 20 (2) ◽  
pp. 175-183
Author(s):  
Susanne Regus ◽  
Felix Klingler ◽  
Werner Lang ◽  
Alexander Meyer ◽  
Veronika Almási-Sperling ◽  
...  
Keyword(s):  
Pilot Study ◽  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Fluorescence Angiography ◽  
Hemodialysis Access ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Access Surgery ◽  
Indocyanine Green Fluorescence Angiography ◽  
Intraoperative Fluorescence

Introduction: In this pilot study, we used indocyanine green fluorescence angiography during hemodialysis access surgery. The aim was to evaluate its relevance as a diagnostic tool to visualize changes in hand microperfusion. Patients and methods: In this prospective single-center study, 47 adult patients (33 male, 14 female) with renal disease (24 preemptive, 23 endstage) were enrolled. Surgical creation of an arteriovenous fistula was performed (22 forearm, 25 upper arm). Microperfusion of the ipsilateral hand and fingers was evaluated intraoperatively using indocyanine green fluorescence angiography. We compared the cumulated microperfusion parameters ingress (In) and ingress rate (InR) before and after opening of the anastomosis. To compare the dimension of microcirculatory decline, we calculated the ratios of the parameters (RatioIn and RatioInR) after to those before anastomosis opening. Results: The cumulated microperfusion parameters In and InR showed a significant decrease after completion of anastomosis and declamping. This effect has been seen in all patients for the hand and for each finger consecutively. During follow-up (mean 4.6, range 3–11 months), 5 patients (10.6%) complained about hemodialysis access–induced distal ischemia. The ratio of intraoperative microperfusion in those five hemodialysis access–induced ischemia patients was significantly lower compared to asymptomatic patients (RatioIn 0.23 vs 0.58, p = 0.001, and RatioInR 0.25 vs 0.62, p = 0.003). Conclusion: Intraoperative fluorescence angiography could visualize the deterioration of ipsilateral hand microperfusion after surgical creation of an arteriovenous fistula. It seems to be a promising tool to detect patients at risk for hemodialysis access–induced distal ischemia early in the peri- or even intraoperative stage.

Indocyanine green fluorescence angiography: a new ERAS item

2018 ◽  
Vol 70 (4) ◽  
pp. 427-432 ◽  
Author(s):  
Antonio Brescia ◽  
Massimo Pezzatini ◽  
Gherardo Romeo ◽  
Matteo Cinquepalmi ◽  
Fioralba Pindozzi ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Fluorescence Angiography ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Indocyanine Green Fluorescence Angiography
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