A Review of Indocyanine Green Fluorescent Imaging in Surgery

Alander, Jarmo T.; Kaartinen, Ilkka; Laakso, Aki; Pätilä, Tommi; Spillmann, Thomas; Tuchin, Valery V.; Venermo, Maarit; Välisuo, Petri

doi:10.1155/2012/940585

Cited by 1,105 publications

(953 citation statements)

References 246 publications

(199 reference statements)

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“…Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy of visceral blood supply and evaluation of bowel perfusion (1)(2)(3)(4)(5)(6)(7)(8)(9). Injected ICG binds tightly to lipoproteins and is rapidly excreted into the bile (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Review Articlementioning

confidence: 99%

“…Injected ICG binds tightly to lipoproteins and is rapidly excreted into the bile (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Review Articlementioning

confidence: 99%

“…Recently, indocyanine green (ICG)-enhanced fluorescence has been used to improve visualization and to provide detailed anatomical information during different surgical procedures, especially laparoscopic surgery (1)(2)(3)(4)(5)(6)(7)(8). Fluorescent optical guidance minimizes inadvertent tissue injury while enhancing procedural efficiency (9).…”

Section: Introductionmentioning

confidence: 99%

“…Indocyanine green is a water-soluble anionic amphiphilic tricarbocyanine dye with a molecular weight of 774.96 Da (1)(2)(3)(4)(5)(6)(7)(8)(9). This dye can be injected into the human bloodstream with practically no adverse effects (10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and becomes fluorescent upon excitation by a laser beam or by light with a wavelength in the near infra-red (NIR) spectrum (approximately 820 nm).…”

Section: Introductionmentioning

confidence: 99%

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Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

Lavazza

Liu

et al. 2016

Gland Surg.

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Identification of the parathyroid glands during thyroid surgery may prevent their inadvertent surgical removal and thus provide a better postoperative quality of life. Nevertheless, the most common "technique" for intraoperative evaluation of perfusion of parathyroid gland tissues during thyroid surgery is visual inspection of the physical condition of tissues, e.g., their color and bleeding edges. Another technique is measurement of intact parathyroid hormone. Recently, indocyanine green-enhanced fluorescence has been used in various surgical techniques, particularly laparoscopic surgery, to improve visualization and to provide detailed anatomical information. Fluorescent optical guidance helps surgeons to avoid inadvertent tissue injury while enhancing procedural efficiency. This technique has potential use for evaluating perfusion of the parathyroid gland in real-time intraoperative angiography.

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Section: Review Articlementioning

confidence: 99%

“…Injected ICG binds tightly to lipoproteins and is rapidly excreted into the bile (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Review Articlementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

Lavazza

Liu

et al. 2016

Gland Surg.

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“…1 Initially, ICG was used for quantitative measurements of hepatic and cardiac function. 2 When ICG is injected intravenously, it binds to plasma proteins, such as albumin, and lipoproteins.…”

Section: Introductionmentioning

confidence: 99%

Indocyanine Green-Fluorescent Pancreatic Perfusion-Guided Resection of Distal Pancreas in Solid Pseudopapillary Neoplasm: Usefulness and Feasibility During Pancreaticobiliary Surgery

Kim

Rho

2018

J Minim Invasive Surg

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ICG is widely applied in real-time imaging during abdominal surgery, plastic surgery, as well as oncologic staging and treatment. A twenty-eight year-old female patient was found to have a 4.5 cm solid pseudopapillary neoplasm in the tail of the pancreas. Under ICG-fluorescent pancreatic perfusion-guidance, we easily defined the margin of the pancreatic tumor and secured the resection margin when performing laparoscopic distal pancreatosplenectomy in the patient. No clinically relevant complications, including postoperative pancreatic fistula, were noted. Intravenous ICG can be very easily and quickly detected in the pancreas under near infrared light. This enhanced vision gives strong contrast to the organ compared to a necrotic tumor with poor blood perfusion, such as solid pseudopapillary neoplasm. Based on our current experience, ICG pancreatic perfusion-guided determination of appropriate resection margin is useful and feasible during pancreaticoduodenectomy.

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Intraoperative Laser-Assisted Indocyanine Green Imaging for Objective Measurement of the Vascular Delay Technique in Locoregional Head and Neck Flaps

Lee

Boahene

et al. 2014

JAMA Facial Plast Surg

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IMPORTANCE Reconstruction of oncologic or traumatic head and neck defects often requires complex planning of locoregional, pedicled, or interpolated flaps. In cases with a higher risk of flap failure, vascular delay with staged reconstruction can help improve tissue perfusion and increase chances of flap survival. An objective tool is needed to help guide reconstructive surgeons with the intraoperative decision to pursue vascular delay. OBJECTIVES To describe a pilot study using a novel application of a technique that quantifies and validates the benefit of the vascular delay procedure in locoregional flaps and to demonstrate a practical and broadly applicable technology that can be easily incorporated into intraoperative decision making and improve outcomes for high-risk flaps. DESIGN, SETTING, AND PARTICIPANTS A pilot study using intraoperative laser-assisted indocyanine green imaging measurements and fluorescence videos to objectively measure the benefit of vascular delay procedures in patients with head and neck defects and wound healing risk factors requiring locoregional flap reconstruction at an academic tertiary care center. MAIN OUTCOMES AND MEASURES Intraoperative laser-assisted indocyanine green imaging with video documentation and quantitative measurements was used to evaluate flap perfusion before a vascular delay procedure. Measurements were repeated after a 3-week vascular delay procedure. RESULTS Two patients were identified based on comorbid conditions that resulted in a higher risk of flap failure, as well as the need for a locoregional flap for reconstruction. At the initial elevation of the flap, quantitative results from flap imaging demonstrated low perfusion numbers and minimal fluorescence, suggesting poor tissue perfusion and increased likelihood of postoperative flap compromise or failure. Following a vascular delay of 3 weeks, repeat measurements were substantially improved. No wound healing issues were observed. CONCLUSIONS AND RELEVANCE This is the first study to date to quantitatively demonstrate the benefit of the vascular delay technique in patients with potential vascular compromise in locoregional head and neck flap reconstruction. Data obtained suggest that this technology can be used to guide intraoperative decision making in complicated reconstructions and help optimize patient outcomes. LEVEL OF EVIDENCE NA.

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A Review of Indocyanine Green Fluorescent Imaging in Surgery

Cited by 1,105 publications

References 246 publications

Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

Indocyanine Green-Fluorescent Pancreatic Perfusion-Guided Resection of Distal Pancreas in Solid Pseudopapillary Neoplasm: Usefulness and Feasibility During Pancreaticobiliary Surgery

Intraoperative Laser-Assisted Indocyanine Green Imaging for Objective Measurement of the Vascular Delay Technique in Locoregional Head and Neck Flaps

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