Near-infrared fluorescence imaging with indocyanine green in vascular surgery

Hoven, P. van den (2022)

Doctoral Thesis

Near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) is a promising imaging technique for the assessment of tissue perfusion. This thesis describes the quest for valid and reliable quantitative assessment of tissue perfusion using this technique, predominantly in patients with lower extremity arterial disease. Two systematic reviews were performed, describing the experience with ICG NIR fluorescence imaging within various surgical fields. In three original studies, perfusion patterns were described in various groups, including lower extremity arterial disease, healthy controls and in patients undergoing free flap reconstructive breast surgery. By applying normalization to the quantitative assessment, an increased validity and reliability was seen. To describe potential clinical applications, the use of ICG NIR fluorescence imaging was described for two indications. In patients undergoing unilateral revascularization, quantitative assessment showed an increase of inflow parameters, whilst parameters in the untreated side remained unchanged. In a cohort of patients undergoing amputation surgery, ICG NIR fluorescence imaging was able to predict postoperative skin necrosis in all four cases. Future use of ICG NIR fluorescence imaging should focus on improving validity and reliability of quantitative perfusion assessment.

• Near-infrared
• Fluorescence
• Imaging
• Indocyanine green
• Perfusion
• Vascular surgery
• Lower extremity arterial disease
• Amputation
• Revascularization
• Quantification

• All authors: Hoven, P. van den
• Supervisor: Hamming, J.F.
• Co-supervisor: Vorst, J.R. van der: Vahrmeier, A.L.
• Committee: Quax, P.H.A.; burggraaf, J.; Geelkerken, R.H.; Yeung, K.K.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2022-06-09
• ISBN (print): 9789464238242