Article

The determination of tissue perfusion and collateralization in peripheral arterial disease with indocyanine green fluorescence angiography.

Clinic for Vascular Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Clinical hemorheology and microcirculation (impact factor: 3.4). 01/2012; 50(3):157-66. DOI:10.3233/CH-2011-1408 pp.157-66
Source: PubMed

ABSTRACT Indocyanine green (ICG) fluorescence angiography is used to evaluate tissue perfusion in many different medical fields. This study aims to evaluate the value of ICG angiography in the determination of tissue perfusion in the PAD lower extremities.
In a prospective clinical study, ICG angiography was used to evaluate tissue perfusion and collateralization in 30 PAD patients. The perfusion index and maximum fluorescence intensity (MPI) were calculated as arterial perfusion parameters.
Significant differences in the perfusion index were found for the different PAD stages (p < 0.001). Poor collateralization was associated with a significantly lower perfusion index than good collateralization (p = 0.003). A ROC analysis for the perfusion index showed a positive likelihood ratio of 6.00 and a negative likelihood ratio of 0.00 with an area under the curve of 0.949 to discriminate critical and non-critical PAD.
ICG angiography is a promising diagnostic tool to quantify tissue perfusion and demonstrate critical limb ischemia and collateralization in lower extremities affected by PAD.

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Keywords

30 PAD patients
 
arterial perfusion parameters
 
collateralization
 
critical limb ischemia
 
different medical fields
 
different PAD stages
 
discriminate critical
 
good collateralization
 
ICG
 
ICG angiography
 
Indocyanine green
 
lower perfusion index
 
maximum fluorescence intensity
 
negative likelihood ratio
 
perfusion index
 
positive likelihood ratio
 
promising diagnostic tool
 
prospective clinical study
 
ROC analysis
 
tissue perfusion