Efficacy of intraoperative HyperEye Medical System angiography for coronary artery bypass grafting

Yamamoto, Masaki; Orihashi, Kazumasa; Nishimori, Hideaki; Handa, Takemi; Kondo, Nobuo; Fukutomi, Takashi; Sato, Takayuki

doi:10.1007/s00595-014-1015-0

Cited by 30 publications

(7 citation statements)

References 16 publications

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“…Indocyanine green (ICG) is used for evaluation of liver function, cardiac output, and so on [9]. The emission of fluorescence by ICG can be detected even within deeply located structures because it is transmitted through tissue [10, 11]; therefore, ICG-based optical imaging can provide minimally invasive imaging of vessels and lymphatic ducts deep inside organs, and real-time imaging during surgery. ICG-based imaging has been recently used in the field of thoracic surgery for early-stage lung tumor.…”

Section: Introductionmentioning

confidence: 99%

Clinical study of video-assisted thoracoscopic surgery wedge resection in early-stage lung cancer by tumor mapping with indocyanine green.

Zhong¹,

Hu²,

Li³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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AimThis study aimed to assess the clinical effectiveness of video-assisted thoracoscopic surgery (VATS) in early-stage lung cancer by indocyanine green (ICG) for tumor mapping.Material and methodsThirty patients with early-stage lung cancer with peripheral nodules smaller than 2 cm scheduled for computed tomography (CT)-guided microcoil placement followed by ICG tumor mapping by VATS wedge resection were enrolled. After microcoil deployment, 100 to 150 ml of diluted ICG was injected percutaneously near the nodule. The nodule initially was localized solely by using a near-infrared ray (NIR) thoracoscope to visualize ICG fluorescence. Thoracoscopic instruments were used to determine the staple line. Wedge resection was performed after confirmation of the location of the microcoil using fluoroscopy and pathology results.ResultsThirty patients underwent VATS resection. The median tumor size was 1.3 cm by CT. The median depth from the pleural surface was 1.7 cm (range: 0.5–3.8 cm). The median CT-guided intervention time was 25 min, and VATS procedural time was 50 min. ICG fluorescence was clearly identified in 30 of 30 patients (100%). The surgical margins were all negative on final pathology in all included cases. The final diagnoses were 30 primary lung cancers; none needed additional resection.ConclusionsCT-guided percutaneous ICG injection and intraoperative NIR localization of small nodules are safe and feasible. These offer surgeons the ease of localization through direct indocyanine green fluorescence imaging without the use of fluoroscopy and may be a complementary technique to preoperative microcoil placement for nonvisible, nonpalpable intrapulmonary nodules.

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Section: Introductionmentioning

confidence: 99%

Clinical study of video-assisted thoracoscopic surgery wedge resection in early-stage lung cancer by tumor mapping with indocyanine green.

Zhong¹,

Hu²,

Li³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

“…Indocyanine green (ICG) is used for evaluation of liver function, cardiac output, and so on (3). The emission of fluorescence by ICG can be detected even within deeply located structures because it is transmitted through tissue (4,5); therefore, ICG-based optical imaging can provide minimally invasive imaging of vessels and lymphatic ducts deep inside organs, and real-time imaging during surgery. ICG-based imaging has been recently used in the field of thoracic surgery for lung segmentectomy.…”

Section: Introductionmentioning

confidence: 99%

Recent fluorescence-based optical imaging for video-assisted thoracoscopic surgery segmentectomy

Matsuura¹,

Mun²,

Ichinose³

et al. 2019

Ann. Transl. Med

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Background: The importance of fluorescence-based optical imaging in various fields of surgery is increasing. This is a prospective cohort study aimed to investigate the feasibility and efficacy of indocyaninegreen fluorescence (ICGF)-based navigation for near-infrared (NIR) thoracoscopic segmentectomy. Methods: ICGF-based video-assisted thoracoscopic surgery (VATS) segmentectomy was performed in 149 patients. Each patient underwent preoperative evaluation by multidetector-row computed tomography (MDCT), which provided three-dimensional simulations of vascular structures, segmental bronchi, and lung tumor. During the procedure, low-dose ICG (0.25 mg/kg) was injected systemically after the target segmental pulmonary arteries and bronchus were divided. Under NIR-thoracoscopic guidance, an ICG fluorescent line was marked by electric scalpel, followed by division of lung parenchyma along the line by electric scalpel or endoscopic staples. Results: An intersegmental line of ICGF was visible in 98% of patients, even with the use of low-dose ICG. Neither ICG-related adverse events nor procedure-related major complications occurred. The 5-year overall (OS) and recurrence-free survival (RFS) rates were 91.8% and 98%, respectively. Localized recurrence at the resected site did not occur in any patient. Conclusions: ICGF-based navigation for NIR VATS segmentectomy for patients with lung cancer is feasible and effective.

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“…The process takes <5 minutes. [ 3 ] We therefore decided to inject ICG intraoperatively in the current patient to assess the patency of the bypass graft and the quality of the anastomosis, and to direct graft revision.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 , 2 ] Moreover, ICGA can evaluate blood flow to the intestines and peripheral arteries during cardiovascular surgery, thus allowing the real-time detection of signs of organ ischemia. [ 2 ] Yamamoto et al [ 3 ] pointed out that intraoperative ICGA could accurately predict graft patency 1 year after CABG. These benefits mean that ICGA has attracted increasing attention in recent years.…”

Section: Introductionmentioning

confidence: 99%

Severe hemodynamic instability after indocyanine green injection during off-pump coronary artery bypass grafting

Zhai

Wang²,

Tian³

2017

Medicine

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Rationale:The increasingly intraoperative use of indocyanine green (ICG) means that it is necessary to be aware of both its advantages and potential adverse effects.Patient concerns:A 76-year-old woman developed symptoms of sudden severe hemodynamic instability while undergoing coronary artery bypass grafting with ICG injection to detect the patency of the graft. The main clinical manifestations were a sudden drop in blood pressure and increased heart rate.Diagnoses:Severe side effects or allergic reaction of ICG.Interventions:Cardiopulmonary bypass (CPB) was established, and an intra-aortic balloon pump was implanted in the left femoral artery after intravenous epinephrine and manual cardiac compression failed.Outcomes:The patient was extubated and transferred to the general ward on the third postoperative day.Lessons:Invasive blood pressure monitoring should be carried out in patients undergoing intraoperative ICG administration. Anesthetists should pay close attention to the patient's hemodynamic fluctuations, and effective emergency measures should be implemented immediately if severe hemodynamic instability occurs.

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Efficacy of intraoperative HyperEye Medical System angiography for coronary artery bypass grafting

Abstract: HEMS angiography of a bypass graft may provide an accurate prediction of the graft patency after surgery.

Cited by 30 publications

References 16 publications

Clinical study of video-assisted thoracoscopic surgery wedge resection in early-stage lung cancer by tumor mapping with indocyanine green.

Clinical study of video-assisted thoracoscopic surgery wedge resection in early-stage lung cancer by tumor mapping with indocyanine green.

Recent fluorescence-based optical imaging for video-assisted thoracoscopic surgery segmentectomy

Severe hemodynamic instability after indocyanine green injection during off-pump coronary artery bypass grafting

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