J Korean Neurosurg Soc.  2015 Dec;58(6):513-517. 10.3340/jkns.2015.58.6.513.

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

• Cho WS
• Kim JE
• Kim SH
• Kim HC
• Kang U
• Lee DS

• KMID: 2151152
• DOI: http://doi.org/10.3340/jkns.2015.58.6.513

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 30degrees. 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.

Keyword

Indocyanine green fluorescence angiography; Aneurysm surgery; Endoscopy

MeSH Terms

Anesthesia, General
Aneurysm
Angiography
Arteries
Brain
Craniotomy
Ear
Endoscopes
Endoscopy
Fluorescein Angiography*
Fluorescence*
Humans
Indocyanine Green*
Male
Neuroendoscopy
Optical Imaging
Parents
Swine*
Veins
Indocyanine Green

Figure

• 

  Fig. 1 Schematic illustration (A) and real model (B) of the endoscopic indocyanine green (ICG) fluorescence angiography.

• 

  Fig. 2 Schematic illustration (A) and real model (B) of the white light and near infrared (NIR) laser sources.

• 

  Fig. 3 Schematic illustration (A) and real model (B) of the fluorescence navigation surgery (FNS) camera.

• 

  Fig. 4 Endoscopic visible color and ICG fluorescent images. A : Photography of the exposed brain cortex in the swine. Endoscopic imaging was targeted for the dotted circle area. B : ICG fluorescent image (left), visible color image (middle), and and real-time merging image of ICG fluorescent and visible color images (right).

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