Indocyanine-green fluorescence video anglography used clinically to evaluate tissue perfusion in microsurgery
Indocyanine-green fluorescence video anglography used clinically to evaluate tissue perfusion in microsurgery
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DOI：
10.1097/01.ta.0000123041.47008.70
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发表时间：
2004-11-01
影响因子：
--
通讯作者：
Bach, O
中科院分区：
文献类型：
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作者：
Mothes, H;Dönicke, T;Bach, O
背景：吲哚菁绿激光诱导荧光血管造影（ICG - FA）是一种新的诊断方法，它能够对显微外科手术中的组织灌注进行定量评估，以及对染料标记血液的摄取、分布和清除情况进行分析。
方法：在不同手术过程中和术后，将ICG - FA技术与临床参数（肿胀度、温度、再灌注时间、穿刺后出血情况）进行比较，评估其敏感性和预后价值。在微血管修复（n = 43）和游离皮瓣手术（n = 48）病例中，总共进行了91次测量。
结果：由于ICG - FA结果与临床发现之间存在差异，术后计划的处理方式改变了43次（47.2%）。在随后导致组织坏死的微血管修复病例中，ICG荧光的预后价值显著高于任何临床参数（p = 0.03）。在游离皮瓣手术中，术中ICG - FA对皮瓣坏死的敏感性优于临床参数，但术后ICG - FA则不然。
结论：ICG荧光血管造影是一种在创伤外科和显微外科中检测组织灌注受损的敏感诊断工具。它的使用可能会改善围手术期的管理，从而带来更好的临床效果。
Background: Laser-induced fluorescence angiography with indocyanine-green (ICG-FA) is a new diagnostic approach that allows quantitative evaluation of tissue perfusion in microsurgery as well as an analysis of the uptake, distribution, and clearance of dye-marked blood.Methods: The ICG-FA technique was evaluated for its sensitivity and prognostic value in comparison with clinical parameters (turgor, temperature, reperfusion time, bleeding after puncture) during and after different surgical procedures. Altogether, 91 measurements were made in cases of microvascular repair (n = 43) and free-flap surgery (n = 48).Results: Because of discrepancies between ICG-FA results and clinical findings, the planned postoperative management was changed 43 times (47.2%). In cases of microvascular repair that subsequently resulted in tissue necrosis, ICG fluorescence had a significantly higher prognostic value than any of the clinical parameters (p = 0.03). During free-flap surgery, intraoperative ICG-FA had better sensitivity for flap loss than clinical parameters, but postoperative ICG-FA did not.Conclusion: Fluorescence angiography with ICG is a sensitive diagnostic tool for detecting compromised tissue perfusion in trauma surgery and microsurgery. Its use may improve perioperative management and thereby lead to better clinical results.