Quantitative Evaluation of the Outcomes of Revascularization Procedures for Peripheral Arterial Disease Using Indocyanine Green Angiography

• Published in: European journal of vascular and endovascular surgery Vol. 46; no. 4; pp. 460 - 465
• Main Authors: Igari, K, Kudo, T, Toyofuku, T, Jibiki, M, Inoue, Y, Kawano, T
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-10-2013
• Subjects: Aged; Aged, 80 and over; Ankle Brachial Index; Blood Flow Velocity; Bypass surgery; Critical limb ischemia; Endovascular Procedures; Endovascular treatment; Female; Fluorescent Dyes; Humans; Indocyanine Green; Indocyanine green angiography; Male; Middle Aged; Perfusion Imaging - methods; Peripheral arterial disease; Peripheral Arterial Disease - diagnosis; Peripheral Arterial Disease - physiopathology; Peripheral Arterial Disease - therapy; Predictive Value of Tests; Regional Blood Flow; ROC Curve; Surgery; Time Factors; Treatment Outcome; Vascular Surgical Procedures; Indocyanine green angiography; Peripheral arterial disease; Bypass surgery; Critical limb ischemia; Endovascular treatment
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2013.07.016

Objectives We performed indocyanine green angiography (ICGA) in patients with peripheral arterial disease (PAD), and established a method for the quantitative measurement of appropriate parameters to assess peripheral perfusion and the applicability of ICGA tests. Methods Twenty-one patients with PAD underwent revascularization procedures with pre- and postinterventional ICGA tests. The ICGA parameters, which included the magnitude of intensity of indocyanine green, the time to maximum intensity, and the time from fluorescence onset to half the maximum intensity (T1/2 ) were compared with the ankle-brachial pressure index, toe -brachial pressure index, and toe pressure. We evaluated these parameters for regions of interest (ROIs). Results T1/2 was the strongest parameter among all parameters of the ICGA tests. ROI 3, which included the distal region of the first metatarsal bone, correlated more significantly with the traditional measurements than the other ROIs. A value of T1/2 >20 seconds for ROI 3 was significantly correlated with a toe pressure of <50 mmHg (sensitivity: 0.77, specificity: 0.80). Conclusions ICGA can be used to assess peripheral tissue perfusion. By measuring the value of T1/2 in ROI 3, ICGA tests can be used to evaluate the outcomes of revascularization procedures.