Early quantitative evaluation of indocyanine green angiography in patients with critical limb ischemia

Braun, Jonathan D.; Trinidad-Hernández, Magdiel; Perry, Diana; Armstrong, David G.; Mills, Joseph L.

doi:10.1016/j.jvs.2012.10.113

Cited by 89 publications

(91 citation statements)

References 17 publications

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“…15,16 While the above points seem laudable, we must consider that the quest for increased efficiency could paradoxically result in decreased quality of care. We have not yet investigated how the additional stimulus of augmented reality impacts performance or whether it might prove too distracting.…”

Section: Discussionmentioning

confidence: 99%

A Heads-Up Display for Diabetic Limb Salvage Surgery

Armstrong

Rankin

Giovinco

et al. 2014

J Diabetes Sci Technol

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Section: Discussionmentioning

confidence: 99%

A Heads-Up Display for Diabetic Limb Salvage Surgery

Armstrong

Rankin

Giovinco

et al. 2014

J Diabetes Sci Technol

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“…Several study groups used ICG-FI for the assessment of tissue perfusion in patients with PAD [5][6][7][8]. Previous studies used the software included in the SPY system (NO- VADAQ , Bonita Springs, USA) for quantitative evaluation of foot perfusion before and after revascularization procedures by correlating results to the maximum fl uorescent intensity and time-dependent maximum intensity [5,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence and prevalence of diabetes mellitus and diabetic foot ulcers are signifi cantly rising [2]. fl ow) of the entire foot, hence providing visual information on the level of micro-perfusion without applying probes or sensors on the skin [5][6][7][8]. Indocyanine green is a dye with an excellent safety profi le and applicable even in patients with renal impairment.…”

Section: Introductionmentioning

confidence: 99%

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Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease

Rieß¹,

Duprée²,

Behrendt³

et al. 2017

Vasa

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Summary:Background: Perioperative evaluation in peripheral artery disease (PAD) by common vascular diagnostic tools is limited by open wounds, medial calcinosis or an altered collateral supply of the foot. Indocyanine green fl uorescent imaging (ICG-FI) has recently been introduced as an alternative tool, but so far a standardized quantitative assessment of tissue perfusion in vascular surgery has not been performed for this purpose. The aim of this feasibility study was to investigate a new software for quantitative assessment of tissue perfusion in patients with PAD using indocyanine green fl uorescent imaging (ICG-FI) before and after peripheral bypass grafting. Patients and methods: Indocyanine green fl uorescent imaging was performed in seven patients using the SPY Elite system before and after peripheral bypass grafting for PAD (Rutherford III-VI). Visual and quantitative evaluation of tissue perfusion was assessed in an area of low perfusion (ALP) and high perfusion (AHP), each by three independent investigators. Data assessment was performed offl ine using a specially customized software package (Institute for Laser Technology, University Ulm, GmbH). Slope of fl uorescent intensity (SFI) was measured as time-intensity curves. Values were compared to ankle-brachial index (ABI), slope of oscillation (SOO), and time to peak (TTP) obtained from photoplethysmography (PPG). Results: All measurements before and after surgery were successfully performed, showing that ABI, TTP, and SOO increased signifi cantly compared to preoperative values, all being statistically significant (P < 0.05), except for TTP (p = 0.061). Further, SFI increased signifi cantly in both ALP and AHP (P < 0.05) and correlated considerably with ABI, TTP, and SOO (P < 0.05). Conclusions: In addition to ABI and slope of oscillation (SOO), the ICG-FI technique allows visual assessment in combination with quantitative assessment of tissue perfusion in patients with PAD. Ratios related to different perfusion patterns and SFI seem to be useful tools to reduce factors disturbing ICG-FI measurements.

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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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Early quantitative evaluation of indocyanine green angiography in patients with critical limb ischemia

Cited by 89 publications

References 17 publications

A Heads-Up Display for Diabetic Limb Salvage Surgery

A Heads-Up Display for Diabetic Limb Salvage Surgery

Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease

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

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