Indocyanine Green Angiography: A Helpful Tool for Intraoperative Assessment of Upper Extremity Perfusion

Ghareeb, Paul A.; Neustein, Thomas M.; Fang, Robert C.; Payne, Diane E.S.

doi:10.1097/bth.0000000000000162

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…ICG angiography is used in a range of surgeries, such as for free flaps e.g. in head and neck surgery (35), in the field of upper extremity surgery (36), for assessing parathyroid perfusion during thyroidectomy (37), for breast reconstruction (38), but also for uterine vascular perfusion at the time of radical trachelectomy (39) and organ transplantations (40). Beran et al used ICG after cervico-vaginal anastomosis in baboons to document real-time vascular perfusion of the uterus with utero-ovarian perfusion alone (41,42).…”

Section: Discussionmentioning

confidence: 99%

Intra- and Postoperative Blood Flow Monitoring in a Sheep Model of Uterus Transplantation

Kengelbach‐Weigand

Lotz

Schmid

et al. 2019

In Vivo

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Section: Discussionmentioning

confidence: 99%

Intra- and Postoperative Blood Flow Monitoring in a Sheep Model of Uterus Transplantation

Kengelbach‐Weigand

Lotz

Schmid

et al. 2019

In Vivo

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“…The flow to digit tips is a particulate example where small-vessel spasms (common and proper digital vessels) confound the clinical assessment. Ghareeb et al [ 95 ] described three cases in which this utility proved to be of great help (two were traumatic, while the third was a case of Reynaud’s ischemia): Injection of 5 mL dye solution with a 10cc NS flush. At the same time, the tissues of concern were centered on the device’s screen.…”

Section: The Uses Of Icg In Traumamentioning

confidence: 99%

“…Moreover, the percentage of fluorescence helps quantify the perfusion adequacy. These findings can help salvage decisions and attempt revascularization, replantation, or conservative amputation[ 95 ]. Mothes et al [ 96 ] modified ICG angiography treatments and predicted failure in a superior manner to traditional clinical indicators (capillary refill, turgor, bleeding, and temperature)[ 93 ].…”

Section: The Uses Of Icg In Traumamentioning

confidence: 99%

Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

Abdelrahman¹,

El‐Menyar²,

Peralta³

et al. 2023

World J Gastrointest Surg

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Background: Modern surgical medicine strives to manage trauma while improving outcomes using functional imaging. Identification of viable tissues is crucial for the surgical management of polytrauma and burn patients presenting with soft tissue and hollow viscus injuries. Bowel anastomosis after trauma-related resection is associated with a high rate of leakage. The ability of the surgeon’s bare eye to determine bowel viability remains limited, and the need for a more standardized objective assessment has not yet been fulfilled. Hence, there is a need for more precise diagnostic tools to enhance surgical evaluation and visualization to aid early diagnosis and timely management to minimize trauma-associated complications. Indocyanine green (ICG) coupled with fluorescence angiography is a potential solution for this problem. ICG is a fluorescent dye that responds to near-infrared irradiation. Methods: We conducted a narrative review to address the utility of ICG in the surgical management of patients with trauma as well as elective surgery. Discussion: ICG has many applications in different medical fields and has recently become an important clinical indicator for surgical guidance. However, there is a paucity of information regarding the use of this technology to treat traumas. Recently, angiography with ICG has been introduced in clinical practice to visualize and quantify organ perfusion under several conditions, leading to fewer cases of anastomotic insufficiency. This has great potential to bridge this gap and enhance the clinical outcomes of surgery and patient safety. However, there is no consensus on the ideal dose, time, and manner of administration nor the indications that ICG provides a genuine advantage through greater safety in trauma surgical settings. Conclusions: There is a scarcity of publications describing the use of ICG in trauma patients as a potentially useful strategy to facilitate intraoperative decisions and to limit the extent of surgical resection. This review will improve our understanding of the utility of intraoperative ICG fluorescence in guiding and assisting trauma surgeons to deal with the intraoperative challenges and thus improve the patients’ operative care and safety in the field of trauma surgery.

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“…Like with red light, NIR has been exploited in numerous LLLT studies [ 114 ], given that mechanisms within photo-biomodulation mediated by red light apply to NIR, given that broad absorption of cytochrome c oxidase (the chromophore indicated in LLLT) [ 115 ]. The most applied photosensitizer with NIR is indocyanine green (ICG), a non-toxic dye used frequently in various medical procedures [ 116 ]. It is used frequently for diagnostic purposes, such as determining liver function and cardiac output [ 116 ].…”

Section: Light-based Anti-infective Agents: Can They Overcome Antimic...mentioning

confidence: 99%

“…The most applied photosensitizer with NIR is indocyanine green (ICG), a non-toxic dye used frequently in various medical procedures [ 116 ]. It is used frequently for diagnostic purposes, such as determining liver function and cardiac output [ 116 ]. In addition, it absorbs wavelengths within the red light and NIR (600–900 nm) spectral regions, which also permits its function as an imaging agent, which is facilitated by the great penetrating capacity of NIR [ 116 ].…”

Section: Light-based Anti-infective Agents: Can They Overcome Antimic...mentioning

confidence: 99%

Antimicrobial Resistance: Is There a ‘Light’ at the End of the Tunnel?

Leanse,

Marasini,

dos Anjos

et al. 2023

Antibiotics

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In recent years, with the increases in microorganisms that express a multitude of antimicrobial resistance (AMR) mechanisms, the threat of antimicrobial resistance in the global population has reached critical levels. The introduction of the COVID-19 pandemic has further contributed to the influx of infections caused by multidrug-resistant organisms (MDROs), which has placed significant pressure on healthcare systems. For over a century, the potential for light-based approaches targeted at combatting both cancer and infectious diseases has been proposed. They offer effective killing of microbial pathogens, regardless of AMR status, and have not typically been associated with high propensities of resistance development. To that end, the goal of this review is to describe the different mechanisms that drive AMR, including intrinsic, phenotypic, and acquired resistance mechanisms. Additionally, the different light-based approaches, including antimicrobial photodynamic therapy (aPDT), antimicrobial blue light (aBL), and ultraviolet (UV) light, will be discussed as potential alternatives or adjunct therapies with conventional antimicrobials. Lastly, we will evaluate the feasibility and requirements associated with integration of light-based approaches into the clinical pipeline.

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Indocyanine Green Angiography: A Helpful Tool for Intraoperative Assessment of Upper Extremity Perfusion

Cited by 5 publications

References 21 publications

Intra- and Postoperative Blood Flow Monitoring in a Sheep Model of Uterus Transplantation

Intra- and Postoperative Blood Flow Monitoring in a Sheep Model of Uterus Transplantation

Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

Antimicrobial Resistance: Is There a ‘Light’ at the End of the Tunnel?

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