Pilot study using intraoperative fluorescence angiography during arteriovenous hemodialysis access surgery

Abstract

Intraoperative fluorescence angiography could visualize the deterioration of ipsilateral hand microperfusion after surgical creation of an arteriovenous fistula. It seems to be a promising tool to detect patients at risk for hemodialysis access-induced distal ischemia early in the peri- or even intraoperative stage.

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

“…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 .…”

“…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 ].…”

“…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 ]. Furthermore, there was a significant difference in the intraoperative ingress ratio and ingress rate ratio in patients who had developed hemodialysis access-induced distal ischemia ( p = 0.001, p = 0.003, respectively) [ 12 ].…”