Quantitative Evaluation of the Outcomes of Revascularization Procedures for Peripheral Arterial Disease Using Indocyanine Green Angiography

Igari, Kimihiro; Kudo, Toshifumi; Toyofuku, Takahiro; Jibiki, Masatoshi; Inoue, Yasuhiro; Kawano, Tatsuyuki

doi:10.1016/j.ejvs.2013.07.016

Cited by 66 publications

(83 citation statements)

References 22 publications

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“…В недавние годы появились работы по оценке ишемии нижних конеч-ностей у пациентов с заболеваниями артерий нижних конечностей, где показаны обнадеживающие резуль-таты применения ФАГ в данной области [8][9][10][11].…”

Section: Discussionunclassified

Near Infrared Imaging for Angiography in Diabetic Patients With Peripheral Artery Disease

Abdulvapova¹,

Grachev²,

Artemova³

et al. 2017

BMP

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The results of evaluation of the soft tissue perfusion of the foot in patients with diabetes and critical lower limb ischemia (CLI) via fluorescence angiography (FAG) in the near-infrared range are represented in the article. The study included 4 diabetic patients with CLI. All patients underwent lower-limb balloon percutaneous transluminal angioplasty. To evaluate the soft tissue perfusion of the foot via FAG the following parameters have been used: T 0m -time to reach maximum for fluorescence intensity after intravenous administration of Indocyanine green; T Im -time of onset of maximum fluorescence intensity after its appearance in the area of interest; I m -the level of the maximum fluorescence intensity. The region of interest was the skin around the wound of the foot. The median FAG parameters in the region of interest on the foot were as follows: prior to surgery T 0m = 164 sec (148-181), T Im = 48 sec (38-56); after surgery: T 0m = 80 sec (69-92); T Im = 27 sec (20-39); (p <0,05). No adverse reactions were registered in the study. Despite the small sample we were able to achieve statistical significance in the difference between the parameters prior to and after surgery. Further prospective studies with extended samples of patients are needed. Keywords: diabetes, peripheral arterial disease, critical limb ischemia, endovascular treatment, near infrared imaging, indocyanine green angiography Contacts: Abdulvapova Z.N., e-mail: zera1987@mail.ru For citations: Abdulvapova Z.N., Grachev P.V., Artemova E.V., Galstyan G.R., Bondarenko O.N., Gorbacheva A.M., Lin`kov K.G., Loschenov V.B. Near infrared imaging for angiography in diabetic patients with peripheral artery disease, Biomedical Photonics, 2017, T. 6, No. 1, pp. 4-11 (in Russian).Оценка состояния кровотока нижних конечностей у пациентов с сахарным диабетом методом флуоресцентной ангиографии в ближнем инфракрасном диапазоне Резюме В работе представлены результаты оценки перфузии мягких тканей стопы у пациентов с сахарным диабетом и критической ишемией нижних конечностей с помощью метода флуоресцентной ангиографии (ФАГ) в ближнем инфракрасном диапазоне. В исследование были включены 4 пациента с сахарным диабетом и критической ишемией нижних конечностей. Всем пациентам была выполнена чрескожная транслюминальная баллонная ангиопластика артерий нижних конечностей. Для оценки перфузии тканей стопы при помощи метода флуоресцентной ангиографии были определены следующие параметры: T 0m -время достижения максимальной интенсивности флуоресценции с момента внутривенного введения индоцианина зеленого; T Im -время наступления максимальной интенсивности флуоресценции с момента ее появления в зоне интереса; I m -уровень максимальной интенсивности флуоресценции. Зоной интереса являлась кожа в околораневой зоне стопы. В результате были получены медианы параметров ФАГ в исследуемой области стопы: до операции -T 0m = 164 с (от 148 до 181), T Im = 48 с (от 38 до 56), и после операции -T 0m = 80 с (от 69 до 92), T Im = 27 с (от 20 до 39) (р<0,05). В ходе исследовани...

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Section: Discussionunclassified

Near Infrared Imaging for Angiography in Diabetic Patients With Peripheral Artery Disease

Abdulvapova¹,

Grachev²,

Artemova³

et al. 2017

BMP

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“…TTFM and high-frequency epicardial ultrasound have been used as popular tools in CABG [15][16][17][18][19][20][21][22][23][24]. Likewise, ICG-AG has been commonly used for evaluating graft patency.…”

Section: Discussionmentioning

confidence: 99%

New Quantitative Analysis Method Using HyperEye Medical System Image for Coronary Artery Bypass Grafting

Takemi¹,

Orihashi²,

Nishimori³

et al. 2017

Angiol

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Purpose: The current evaluation by indocyanine green angiography in coronary artery bypass patients has been performed by qualitative analysis. We devised an original quantitative analysis method using Image J.Methods: Indocyanine green angiography movie was converted to spatiotemporal images. Using the spatiotemporal image, an indocyanine green fluorescence intensity curve was drawn and converted to a firstderivative (acceleration) curve. Indocyanine green angiography evaluations were classified into four types. We collected the peak indocyanine green fluorescence intensity value (peak-I) and both time interval and ratio of maximum indocyanine green acceleration value (max dI/dt) between the mid and distal portions of the graft. Results:In 61 left internal thoracic artery grafts, 49 were patent and 12 were abnormal on CAG. There were significant differences between peak-I at the mid portion of the graft (221.47 ± 39.33 vs. 184.82 ± 40.15 gray scale) and time delay with max dI/dt (0.45 ± 1.28 vs. −1.00 ± 1.25 s), but there was no significant difference in the ratio of max dI/dt between patent and abnormal grafts. Conclusions:The spatiotemporal image method may become a model of the analysis software and the time interval of max dI/dt may become a predictor for future graft failure.

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“…Among these methods, some showed promising results such as the consecrated transcutaneous oxygen pressure [1-3, 33, 39]; the novel vascular optical tomographic imaging (VOTI) [41]; the "real-time" Laser-Doppler skin perfusion pressure [33,35,39]; the continuous tissue oxygen saturation foot-mapping (StO 2 ); and the recent 99m Tc Scintigraphic, the PET, and the single-photon emission computed tomography (SPECT) scans (owning specific CLI 3-D detection at molecular level) [35,39]. Parallel microcirculatory yet, more invasive exploration was recently documented gathering intraoperative "Indocyanine green" angiography (ICGA) [42,43], the "Indigo Carmine" angiography [44], and the foot "micro-oxygen sensors" (MOXYs) technology, all with encouraging applications during wound-targeted revascularization [45].…”

Section: Current CLI Diagnostic: Can We Effectively Assess the Real Imentioning

confidence: 99%

Ischemic Ulcer Healing: Does Appropriate Flow Reconstruction Stand for All That We Need?

Alexandrescu¹,

Triffaux²

2016

Wound Healing - New Insights Into Ancient Challenges

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During the recent decades, soaring progresses in vascular disease knowledge, particularly in critical limb ischemia (CLI) treatment, enhanced novel diagnostic and interventional strategies with high serviceableness in patient's selection, arterial recanalization, and dedicated ischemic ulcer follow-up. However, despite undeniable advances in medical technology and clinical judgment, limb salvage, the ambulation recovery, and patient's survival seem only scarcely affected in this heterogeneous CLI group, particularly concerning the diabetic and renal patients. Innovative strategies such as "end artery occlusive disease" treatment or "wound-targeted revascularization" were equally proposed by following the angiosomal anatomical distribution associating individual foot collateral assessment in a unified macro-and micro-circulatory judgment. However, despite encouraging clinical results, prospective evidence still lacks on this concern. It also appears that specific wounds could not always stand for the lowest perfusion areas according to current CLI criteria, since severe neuropathy, inflammatory swelling, local infection, and skin trauma may add complementary hindrances to tissue viability.The present chapter endeavor to summarize main available treatment principles for ischemic ulcer recovery that every modern practitioner eventually disposes in an updated contemporary view."

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Quantitative Evaluation of the Outcomes of Revascularization Procedures for Peripheral Arterial Disease Using Indocyanine Green Angiography

Abstract: ICGA can be used to assess peripheral tissue perfusion. By measuring the value of T1/2 in ROI 3, ICGA tests can be used to evaluate the outcomes of revascularization procedures.

Cited by 66 publications

References 22 publications

Near Infrared Imaging for Angiography in Diabetic Patients With Peripheral Artery Disease

Near Infrared Imaging for Angiography in Diabetic Patients With Peripheral Artery Disease

New Quantitative Analysis Method Using HyperEye Medical System Image for Coronary Artery Bypass Grafting

Ischemic Ulcer Healing: Does Appropriate Flow Reconstruction Stand for All That We Need?

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