Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Endoscopic Fluorescence Angiography with Indocyanine Green : A Preclinical Study in the Swine

  • Cho, Won-Sang (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Jeong Eun (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Sae Hoon (Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Hee Chan (Department of Biomedical Engineering, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kang, Uk (Korea Electrotechnology Research Institute Russia Science Seoul Center) ;
  • Lee, Dae-Sic (Korea Electrotechnology Research Institute Russia Science Seoul Center)
  • Received : 2015.05.14
  • Accepted : 2015.08.31
  • Published : 2015.12.28
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : Microscopic indocyanine green (ICG) angiography is useful for identifying the completeness of aneurysm clipping and the preservation of parent arteries and small perforators. Neuroendoscopy is helpful for visualizing structures beyond the straight line of the microscopic view. We evaluated our prototype of endoscopic ICG fluorescence angiography in swine, which we developed in order to combine the merits of microscopic ICG angiography and endoscopy. Methods : Our endoscopic ICG system consists of a camera, a light source, a display and software. This system can simultaneously display real-time visible and near infrared fluorescence imaging on the same monitor. A commercially available endoscope was used, which was 4 mm in diameter and had an angle of $30^{\circ}$. A male crossbred swine was used. Results : Under general anesthesia, a small craniotomy was performed and the brain surface of the swine was exposed. ICG was injected via the ear vein with a bolus dose of 0.3 mg/kg. Visible and ICG fluorescence images of cortical vessels were simultaneously observed on the display monitor at high resolution. The real-time merging of the visible and fluorescent images corresponded well. Conclusion : Simultaneous visible color and ICG fluorescent imaging of the cortical vessels in the swine brain was satisfactory. Technical improvement and clinical implication are expected.

Keywords

References

  1. Alexander TD, Macdonald RL, Weir B, Kowalczuk A : Intraoperative angiography in cerebral aneurysm surgery : a prospective study of 100 craniotomies. Neurosurgery 39 : 10-17; discussion 17-18, 1996 https://doi.org/10.1097/00006123-199607000-00004
  2. Andaluz N, Zuccarello M : Recent trends in the treatment of cerebral aneurysms : analysis of a nationwide inpatient database. J Neurosurg 108 : 1163-1169, 2008 https://doi.org/10.3171/JNS/2008/108/6/1163
  3. Betz CS, Zhorzel S, Schachenmayr H, Stepp H, Havel M, Siedek V, et al. : Endoscopic measurements of free-flap perfusion in the head and neck region using red-excited Indocyanine Green : preliminary results. J Plast Reconstr Aesthet Surg 62 : 1602-1608, 2009 https://doi.org/10.1016/j.bjps.2008.07.042
  4. Brown RD Jr, Broderick JP : Unruptured intracranial aneurysms : epidemiology, natural history, management options, and familial screening. Lancet Neurol 13 : 393-404, 2014 https://doi.org/10.1016/S1474-4422(14)70015-8
  5. Bruneau M, Appelboom G, Rynkowski M, Van Cutsem N, Mine B, De Witte O : Endoscope-integrated ICG technology : first application during intracranial aneurysm surgery. Neurosurg Rev 36 : 77-84; discussion 84-85, 2013
  6. Ciamberlini C, Guarnieri V, Longobardi G, Poggi P, Donati MC, Panzardi G : Indocyanine green videoangiography using cooled charge-coupled devices in central serous choroidopathy. J Biomed Opt 2 : 218-225, 1997 https://doi.org/10.1117/12.268939
  7. Fischer G, Oertel J, Perneczky A : Endoscopy in aneurysm surgery. Neurosurgery 70 (2 Suppl Operative) : 184-190; discussion 190-191, 2012
  8. Hernesniemi J, Ishii K, Niemelä M, Smrcka M, Kivipelto L, Fujiki M, et al. : Lateral supraorbital approach as an alternative to the classical pterional approach. Acta Neurochir Suppl 94 : 17-21, 2005 https://doi.org/10.1007/3-211-27911-3_4
  9. Ishihara R, Iishi H, Kidu T, Yamamoto S, Miyoshi R, Inoue T, et al. : Infrared endoscopic system for bleeding-point detection after flushing with indocyanine green solution (with videos). Gastrointest Endosc 68 : 975-981, 2008 https://doi.org/10.1016/j.gie.2008.05.055
  10. Litvack ZN, Zada G, Laws ER Jr : Indocyanine green fluorescence endoscopy for visual differentiation of pituitary tumor from surrounding structures. J Neurosurg 116 : 935-941, 2012 https://doi.org/10.3171/2012.1.JNS11601
  11. Mielke D, Malinova V, Rohde V : Comparison of intraoperative microscopic and endoscopic ICG angiography in aneurysm surgery. Neurosurgery 10 Suppl 3 : 418-425; discussion 425, 2014 https://doi.org/10.1227/NEU.0000000000000345
  12. Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, et al. : International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms : a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366 : 809-817, 2005 https://doi.org/10.1016/S0140-6736(05)67214-5
  13. Nimura H, Narimiya N, Mitsumori N, Yamazaki Y, Yanaga K, Urashima M : Infrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer. Br J Surg 91 : 575-579, 2004 https://doi.org/10.1002/bjs.4470
  14. Nishiyama Y, Kinouchi H, Senbokuya N, Kato T, Kanemaru K, Yoshioka H, et al. : Endoscopic indocyanine green video angiography in aneurysm surgery : an innovative method for intraoperative assessment of blood flow in vasculature hidden from microscopic view. J Neurosurg 117 : 302-308, 2012 https://doi.org/10.3171/2012.5.JNS112300
  15. Park HS, Park SK, Han YM : Microsurgical experience with supraorbital keyhole operations on anterior circulation aneurysms. J Korean Neurosurg Soc 46 : 103-108, 2009 https://doi.org/10.3340/jkns.2009.46.2.103
  16. Quinones-Hinojosa A, Alam M, Lyon R, Yingling CD, Lawton MT : Transcranial motor evoked potentials during basilar artery aneurysm surgery : technique application for 30 consecutive patients. Neurosurgery 54 : 916-924; discussion 924, 2004 https://doi.org/10.1227/01.NEU.0000114511.33035.AF
  17. Raabe A, Beck J, Gerlach R, Zimmermann M, Seifert V : Near-infrared indocyanine green video angiography : a new method for intraoperative assessment of vascular flow. Neurosurgery 52 : 132-139; discussion 139, 2003
  18. Raabe A, Nakaji P, Beck J, Kim LJ, Hsu FP, Kamerman JD, et al. : Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery. J Neurosurg 103 : 982-989, 2005 https://doi.org/10.3171/jns.2005.103.6.0982
  19. Reisch R, Perneczky A : Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision. Neurosurgery 57 (4 Suppl) : 242-255; discussion 242-255, 2005
  20. Smith GA, Dagostino P, Maltenfort MG, Dumont AS, Ratliff JK : Geographic variation and regional trends in adoption of endovascular techniques for cerebral aneurysms. J Neurosurg 114 : 1768-1777, 2011 https://doi.org/10.3171/2011.1.JNS101528
  21. Snyderman CH, Carrau RL, Kassam AB, Zanation A, Prevedello D, Gardner P, et al. : Endoscopic skull base surgery : principles of endonasal oncological surgery. J Surg Oncol 97 : 658-664, 2008 https://doi.org/10.1002/jso.21020
  22. Verbeek FP, van der Vorst JR, Schaafsma BE, Hutteman M, Bonsing BA, van Leeuwen FW, et al. : Image-guided hepatopancreatobiliary surgery using near-infrared fluorescent light. J Hepatobiliary Pancreat Sci 19 : 626-637, 2012 https://doi.org/10.1007/s00534-012-0534-6

Cited by

  1. Association between Blood Flow of the Gastric Tube Using Intraoperative ICG Fluorescence Imaging and Postoperative Endoscopic Findings of the Gastric Tube in Esophagectomy vol.67, pp.6, 2015, https://doi.org/10.2468/jbes.67.386
  2. Keyhole Approach and Neuroendoscopy for Cerebral Aneurysms vol.60, pp.3, 2017, https://doi.org/10.3340/jkns.2017.0101.002
  3. Application of Indocyanine Green Videoangiography in Aneurysm Surgery: Evidence, Techniques, Practical Tips vol.6, pp.None, 2015, https://doi.org/10.3389/fsurg.2019.00034