Indocyanine Green Angiography to Prognosticate Healing of Foot Ulcer in Critical Limb Ischemia: A Novel Technique

Patel, Hiten Mohanbhai; Bulsara, Shahzad; Banerjee, Shubhabrata; Sahu, Tapish; Sheorain, Virender; Grover, Tarun; Parakh, Rajiv

doi:10.1016/j.avsg.2018.02.021

Cited by 16 publications

(22 citation statements)

References 15 publications

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“…Quantitative analysis of fluorescence imaging was conducted in 18 studies included in this review ( n = 683) [ 8 , 11 , 12 , 15 , 16 , 18 , 20 , 29 , 30 , 38 , 39 , 40 , 43 , 44 , 50 , 55 , 60 , 65 ]. Fifteen studies opted for dose-dependent ICG administration, with 10 studies selecting a dose of 0.1 mg/kg [ 12 , 15 , 16 , 20 , 29 , 30 , 38 , 39 , 40 , 43 , 44 , 50 , 55 , 60 , 65 ]. SPY Elite Imaging was the fluorescence imaging system of choice in eight studies, see Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…The Fmax was the most frequently selected parameter (7 studies; n = 297) [ 18 , 29 , 30 , 38 , 39 , 40 , 50 ]. Four studies described a significant difference in the Fmax pre- and post-revascularization, with Nakamura et al mentioning no significant difference in the treated limb, and a significant decrease in the contralateral limb ( p = 0.0875, p = 0.006, respectively) [ 18 , 29 , 38 , 40 ]. No significant difference in Fmax was detected between PAD patients and controls; dialysis patients and controls; Rutherford classification categories; or critical limb ischemia patients and controls [ 30 , 39 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

“…Six studies selected the ingress and ingress rate as perfusion parameters ( n = 237) [ 8 , 12 , 15 , 16 , 18 , 40 ]. Five studies evaluated the ingress in PAD patients, all describing statistically significant results pre- and post-revascularization [ 8 , 15 , 16 , 18 , 40 ]. Regus et al highlighted a statistically significant difference in the ingress and ingress rate pre- and post-arteriovenous anastomotic creation in the hand and fingers of dialysis patients ( p < 0.001) [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…The perfusion parameter Tmax was discussed in six studies ( n = 204) [ 29 , 30 , 38 , 39 , 40 , 55 ]. Heterogenous results were seen in PAD patients pre- and post-revascularization.…”

Section: Resultsmentioning

confidence: 99%

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Perfusion Parameters in Near-Infrared Fluorescence Imaging with Indocyanine Green: A Systematic Review of the Literature

Goncalves

Hoven

Schaik

et al. 2021

Life

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(1) Background: Near-infrared fluorescence imaging is a technique capable of assessing tissue perfusion and has been adopted in various fields including plastic surgery, vascular surgery, coronary arterial disease, and gastrointestinal surgery. While the usefulness of this technique has been broadly explored, there is a large variety in the calculation of perfusion parameters. In this systematic review, we aim to provide a detailed overview of current perfusion parameters, and determine the perfusion parameters with the most potential for application in near-infrared fluorescence imaging. (2) Methods: A comprehensive search of the literature was performed in Pubmed, Embase, Medline, and Cochrane Review. We included all clinical studies referencing near-infrared perfusion parameters. (3) Results: A total of 1511 articles were found, of which, 113 were suitable for review, with a final selection of 59 articles. Near-infrared fluorescence imaging parameters are heterogeneous in their correlation to perfusion. Time-related parameters appear superior to absolute intensity parameters in a clinical setting. (4) Conclusions: This literature review demonstrates the variety of parameters selected for the quantification of perfusion in near-infrared fluorescence imaging.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The perfusion parameter Tmax was discussed in six studies ( n = 204) [ 29 , 30 , 38 , 39 , 40 , 55 ]. Heterogenous results were seen in PAD patients pre- and post-revascularization.…”

Section: Resultsmentioning

confidence: 99%

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Perfusion Parameters in Near-Infrared Fluorescence Imaging with Indocyanine Green: A Systematic Review of the Literature

Goncalves

Hoven

Schaik

et al. 2021

Life

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“…Quantitative ICG NIFA analysis performed before and after revascularization demonstrates correlation with standard perfusion analyses, such as ABIs, and has been shown to predict revascularization success or failure. [70][71][72] Furthermore, ICG NIFA has been shown to reflect differences in perfusion in patients after revascularization even in situations where other perfusion techniques such as ABI and toe pressure often fail, such as in diffuse medial calcification, making its use evident in the CLI patient. 71,[73][74][75] Fig.…”

Section: Surgical Sharp and Conservative Sharp Debridementmentioning

confidence: 99%

On the Cutting Edge: Wound Care for the Endovascular Specialist

Olivieri

Yates

Vianna

et al. 2018

Semin intervent Radiol

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Clinical outcomes in patients with critical limb ischemia (CLI) depend not only on endovascular restoration of macrovascular blood flow but also on aggressive periprocedural wound care. Education about this area of CLI therapy is essential not only to maximize the benefits of endovascular therapy but also to facilitate participation in the multidisciplinary care crucial to attaining limb salvage. In this article, we review the advances in wound care products and therapies that have granted the wound care specialist the ability to heal previously nonhealing wounds. We provide a primer on the basic science behind wound healing and the pathogenesis of ischemic wounds, familiarize the reader with methods of tissue viability assessment, and provide an overview of wound debridement techniques, dressings, hyperbaric therapy, and tissue offloading devices. Lastly, we explore emerging technology on the horizons of wound care.

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Intraoperative angiography imaging correlates with wound complications following soft tissue sarcoma resection

Lazarides

Saltzman

Visgauss

et al. 2022

Journal Orthopaedic Research

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For soft tissue sarcoma patients receiving preoperative radiation therapy, wound complications are common and potentially devastating. The purpose of this study was to assess the feasibility of intraoperative indocyanine green fluorescent angiography (ICGA) as a predictor of wound complications in these patients. A consecutive series of patients with soft tissue sarcoma of the extremities or pelvis who received neoadjuvant radiation and a subsequent radical resection received intraoperative ICGA with the SPY PHI device (Stryker Inc.) at the time of closure. Retrospective analysis of fluorescence signal along multiple points of the wound length was performed and quantified. The primary endpoint was wound complication, defined as delayed wound healing or wound dehiscence, within 3 months of surgery. Fourteen patients with preoperative irradiated soft tissue sarcoma were consecutively imaged. There were six patients with wound complications classified as “aseptic” in five cases. Using the ICGA, blinded surgeons correctly predicted wound complications in 75% of cases. During the inflow phase, a mean ratio of normal of 0.62 maximized the area under the curve (AUC = 0.90) for predicting wound complications with a sensitivity of 100% and specificity of 77.4%. During the peak phase, a mean ratio of normal of 0.55 maximized the AUC (0.95) for predicting wound complications with a sensitivity of 88.9% and a specificity of 100%. Intraoperative use of ICGA may help to predict wound complications in patients undergoing resection of preoperatively irradiated soft tissue sarcomas of the extremities and pelvis.

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Indocyanine Green Angiography to Prognosticate Healing of Foot Ulcer in Critical Limb Ischemia: A Novel Technique

Cited by 16 publications

References 15 publications

Perfusion Parameters in Near-Infrared Fluorescence Imaging with Indocyanine Green: A Systematic Review of the Literature

Perfusion Parameters in Near-Infrared Fluorescence Imaging with Indocyanine Green: A Systematic Review of the Literature

On the Cutting Edge: Wound Care for the Endovascular Specialist

Intraoperative angiography imaging correlates with wound complications following soft tissue sarcoma resection

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