Visualization of bronchial circulation at bronchial anastomotic site using bronchial fluorescein angiography technique
Visualization of bronchial circulation at bronchial anastomotic site using bronchial fluorescein angiography technique
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DOI：
10.1093/icvts/ivw210
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发表时间：
2016-11-01
影响因子：
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通讯作者：
Oto, Takahiro
中科院分区：
文献类型：
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作者：
Iga, Norichika;Miyoshi, Kentaroh;Oto, Takahiro
支气管成形术后成功的支气管愈合主要取决于阻塞部位的支气管循环。我们开发了一种支气管荧光素血管造影（B-FAG）技术，用于可视化支气管表面的循环。该技术在动物中进行了评价，使用黄绿素作为对比剂，自体荧光成像（AFI）支气管镜作为检测器。分离10头猪的左主肺动脉（PA）和主支气管。在切断左主支气管和支气管动脉并重新吻合支气管后，将猪随机分为两组：PA-组（n = 5），其中切断肺动脉; PA+组（n = 5），其中保留肺动脉。静脉注射荧光素后，用自体荧光成像支气管镜观察远端吻合部位30 min。手术干预后2天取样的支气管标本进行组织学评价。在PA-组中，在整个观察时间内远端支气管没有荧光素增强。然而，在PA+组中，在不到207 +/- 102.5 s的时间内清楚地观察到支气管表面从洋红色变为明亮的绿色的增强。支气管荧光素血管造影检测到的增强状态与组织损伤的程度有关，这在急性愈合期的组织学上得到了证实。支气管荧光素血管造影在中央支气管吻合术后立即清楚地显示了循环状态。该技术是预测支气管吻合术后缺血性气道并发症的一种潜在实用方法。
Successful bronchial healing after a bronchoplastic procedure mainly depends on bronchial circulation at the anastomostic site. We developed a bronchial fluorescein angiography (B-FAG) technique for visualizing circulation on the bronchial surface. The technique was evaluated in animals.Fluorescein was used as a contrast agent and an autofluorescence imaging (AFI) bronchoscope as a detector. The left main pulmonary artery (PA) and main bronchus of 10 pigs were isolated. After transection of the left main bronchus and bronchial arteries and re-anastomosis of the bronchus, the pigs were randomly divided into two groups: the PA- group (n = 5), in which the pulmonary artery was transected; and the PA+ group (n = 5), in which the pulmonary artery was preserved. Following intravenous injection of fluorescein, the distal anastomotic site was observed for 30 min with autofluorescence imaging bronchoscopy. Bronchial specimens sampled 2 days after the surgical intervention were histologically evaluated.In the PA- group, there was no fluorescein enhancement in the distal bronchus throughout the observation time. However, enhancement, which turned the bronchial surface from magenta to bright green, was clearly observed in less than 207 +/- 102.5 s in the PA+ group. The enhancement status detected by bronchial fluorescein angiography was related to the extent of tissue damage, as was proven histologically in the acute healing stage.Bronchial fluorescein angiography clearly visualized the circulatory status promptly after the anastomosis procedure at the central bronchus. This technique is a potentially practical approach to predict ischaemic airway complications following bronchial anastomosis.