A novel quantitative evaluation of lower limb ischemia with intraoperative fluorescence angiography by intravenous ICG

Shida Kaoru, Uemura Tetsuji, Yoshimoto Shinya

doi:10.7792/jlspm.5.67

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Other Title

ICG静注による術中蛍光血管造影を用いた新しい下肢虚血の定量評価
ICG ジョウチュウニヨルジュッチュウケイコウケッカンゾウエイオモチイタアタラシイカシキョケツノテイリョウヒョウカ

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Abstract

We performed quantitative evaluation of local tissue blood flow and intraoperatively diagnosed and evaluated the areas of ischemic leg amputation and necrotic tissue debridement by visualizing the extent of feeding vessels using intraoperative fluorescence angiography (indocyanine green angiography; IA) in patients with diabetic foot gangrene and ischemic skin ulcer. As a result, local tissue blood flow could be visualized in all patients, and toe amputation surgery and epidermization could be performed as post-debridement wound-closure measures. We consider that this method will become an assisting measure for the direct observation of local circulation in necrotic areas in patients undergoing debridement for leg lesion and amputation stump plasty. In addition, we consider that perfusion time can be evaluated by visualization and quantitation as a new measurement method to evaluate ischemic legs. It is considered a great advantage that we can obtain more accurate information on tissues and perform minimally invasive surgery by understanding the circulation status of target tissues both visually and numerically immediately before or during surgery, in addition to preoperative blood flow evaluation such as ABI (ankle brachial index) and SPP (skin perfusion pressure).

Journal

The Journal of Japanese Society of Limb Salvage and Podiatric Medicine

The Journal of Japanese Society of Limb Salvage and Podiatric Medicine 5 (2), 67-75, 2013

Japanese Society of Limb Salvage and Podiatric Medicine

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