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Evaluation of graft anastomosis using time–intensity curves and quantitative near-infrared fluorescence angiography during peripheral arterial bypass grafting

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Abstract

Near-infrared fluorescence angiography (NIR) visualizes blood perfusion using the fluorescence property of indocyanine green (ICG). This study aimed to retrospectively determine the usefulness of a quantitative analysis using NIR to predict the patency of peripheral arterial bypass grafts by measuring their fluorescence luminance intensities (FLIs).

Thirteen grafts in 11 patients who underwent peripheral arterial bypass grafting were divided into a patent graft group (n = 7) and a failed graft group (n = 6). The changes in the FLIs of ICG opacification through the graft and distal host artery were retrospectively analyzed using stored NIR data. The time–intensity curves (TICs) of ICG opacification through the graft (Qgraft) and distal host artery (Qdistal) were measured. Two parameters, Δ(Qgraft − Qdistal) and integral(Qgraft − Qdistal), were also analyzed.

Although not significant, decreases in Qgraft were observed in the failed graft groups. The Qdistal of the failed graft group was significantly attenuated as compared with that of the patent graft group. Δ(Qgraft − Qdistal) increased only in the failed graft group, which indicates widening of the gap in FLI. Integral(Qgraft − Qdistal) was higher in the failed graft group, as it reflects the accumulation of ICG opacification.

The TICs were influenced by anastomotic stenosis in the distal site of the host arteries. Our results indicate that the comparison of Δ(Qgraft − Qdistal) and integral (Qgraft − Qdistal) quantitatively analyzed using NIR can potentially predict anastomotic stenosis.

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References

  1. Yamamoto M, Sasaguri S, Sato T. Assessing intraoperative blood flow in cardiovascular surgery. Surg Today. 2011;41:1467–74.

    Article  Google Scholar 

  2. Braun JD, Trinidad-Hernandez M, Perry D, Armstrong DG, Mills JL Sr. Early quantitative evaluation of indocyanine green angiography in patients with critical limb ischemia. J Vasc Surg. 2013;57:1213–8.

    Article  PubMed  Google Scholar 

  3. Benson RC, Kues HA. Fluorescence properties of indocyanine green as related to angiography. Phys Med Biol. 1978;23:159–63.

    Article  CAS  PubMed  Google Scholar 

  4. Yamamoto M, Orihashi K, Nishimori H, Handa T, Kondo N, Fukutomi T, Sato T. Efficacy of intraoperative HyperEye Medical System angiography for coronary artery bypass grafting. Surg Today. 2015;45:966–72.

    Article  Google Scholar 

  5. Taggart DP, Choudhary B, Anastasiadis K, Abu-Omar Y, Balacumaraswami L, Pigott DW. Preliminary experience with a novel intraoperative fluorescence imaging technique to evaluate the patency of bypass grafts in total arterial revascularization. Ann Thorac Surg. 2003;75:870–3.

    Article  PubMed  Google Scholar 

  6. Desai ND, Miwa S, Kodama D, Cohen G, Christakis GT, Goldman BS, Baerlocher MO, Pelletier MP, Fremes SE. Improving the quality of coronary bypass surgery with intraoperative angiography: validation of a new technique. J Am Coll Cardiol. 2005;46:1521–5.

    Article  Google Scholar 

  7. Balacumaraswami L, Taggart DP. Intraoperative imaging techniques to assess coronary artery bypass graft patency. Ann Thorac Surg. 2007;83:2251–7.

    Article  Google Scholar 

  8. Azuma N, Koya A, Uchida D, Saito Y, Uchida H. Ulcer healing after peripheral intervention-can we predict it before revascularization? Circ J. 2014;78:1791–800.

    Article  PubMed  Google Scholar 

  9. Igari K, Kudo T, Toyofuku T, Jibiki M, Inoue Y, Kawano T. Quantitative evaluation of the outcomes of revascularization procedures for peripheral arterial disease using indocyanine green angiography. Eur J Vasc Endovasc Surg. 2013;46:460–5.

    Article  CAS  PubMed  Google Scholar 

  10. D’Ancona G, Bartolozzi F, Bogers AJ, Pilato M, Parrinello M, Kappetein AP. Intraoperative graft patency verification in coronary artery surgery: modern diagnostic tools. J Cardiothorac Vasc Anesth. 2009;23:232–8.

    Article  PubMed  Google Scholar 

  11. Yamamoto M, Nishimori H, Handa T, Fukutomi T, Kihara K, Tashiro M, Sato T, Orihashi K. Quantitative assessment technique of HyperEye medical system angiography for coronary artery bypass grafting. Surg Today. 2017;47:210–7.

    Article  Google Scholar 

  12. Balacumaraswami L, Abu-Omar Y, Choudhary B, Pigott D, Taggart DP. A comparison of transit-time flowmetry and intraoperative fluorescence imaging for assessing coronary artery bypass graft patency. J Thorac Cardiovasc Surg. 2005;130:315–20.

    Article  PubMed  Google Scholar 

  13. Yamamoto M, Nishimori H, Fukutomi T, Handa T, Kihara K, Tashiro M, Sato T, Orihashi K. Influence of vessel stenosis on indocyanine green fluorescence intensity assessed by near-infrared fluorescence angiography. Surg Today. 2017;47:877–82.

    Article  CAS  PubMed  Google Scholar 

  14. Handa T, Orihashi K, Nishimori H, Fukutomi T, Yamamoto M, Kondo N, Tashiro M. Maximal blood flow acceleration analysis in the early diastolic phase for in situ internal thoracic artery bypass grafts: a new transit-time flow measurement predictor of graft failure following coronary artery bypass grafting. Interact Cardiovasc Thorac Surg. 2015;20:449–57.

    Article  PubMed  Google Scholar 

  15. Shintani Y, Iino K, Yamamoto Y, Kato H, Takemura H, Kiwata T. Analysis of computational fluid dynamics and particle image velocimetry models of distal-end side-to-side and end-to-side anastomoses for coronary artery bypass grafting in a pulsatile flow. Circ J. 2017;82:110–7.

    Article  PubMed  Google Scholar 

  16. Hirotani T, Kameda T, Shirota S, Nakao Y. An evaluation of the intraoperative transit time measurements of coronary bypass flow. Eur J Cardiothorac Surg. 2001;19:848–52.

    Article  CAS  PubMed  Google Scholar 

  17. Hol PK, Fosse E, Mork BE, Lundblad R, Rein KA, Lingaas PS, Geiran O, Svennevig JL, Tonnessen TI, Nitter-Hauge S, Due-Tonnessen P, Vatne K, Smith HJ. Graft control by transit time flow measurement and intraoperative angiography in coronary artery bypass surgery. Heart Surg Forum. 2001;4:254–7. (discussion 7–8).

    CAS  PubMed  Google Scholar 

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Acknowledgements

This research was supported by the JSPS KAKENHI (Grant number 20437718) and Fujita Memorial Fund for Medical Research.

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Authors and Affiliations

  1. Department of Operating Management, Kochi Medical School, Kochi University, Kohasu Oko-cho 185-1, Nankoku, Kochi, 783-8505, Japan

    Masaki Yamamoto & Kazuhiro Hanazaki

  2. Department of Surgery 2, Kochi Medical School, Kochi University, Kohasu Oko-cho 185-1, Nankoku, Kochi, 783-8505, Japan

    Masaki Yamamoto, Miwa Tashiro, Takemi Handa & Kazumasa Orihashi

  3. Center for Photodynamic Medicine, Kochi Medical School, Kochi University, Kohasu Oko-cho 185-1, Nankoku, Kochi, 783-8505, Japan

    Masaki Yamamoto, Takayuki Sato, Keiji Inoue, Kazumasa Orihashi & Kazuhiro Hanazaki

  4. Integrated Centre for Advanced Medical Technologies, Kochi Medical School, Kochi University, Kohasu Oko-cho 185-1, Nankoku, Kochi, 783-8505, Japan

    Hitoshi Ninomiya

  5. Faculty of Science and Engineering, Department of Civil and Environmental Engineering, Toyo University, 2100, Kujirai, Kawagoe, Saitama, 350-8585, Japan

    Hitoshi Ninomiya

  6. Department of Cardiovascular Control, Kochi Medical School, Kochi University, Kohasu Oko-cho 185-1, Nankoku, Kochi, 783-8505, Japan

    Takayuki Sato

  7. Department of Urology, Kochi Medical School, Kochi University, Kohasu Oko-cho 185-1, Nankoku, Kochi, 783-8505, Japan

    Keiji Inoue

  8. Department of Surgery 1, Kochi Medical School, Kochi University, Kohasu Oko-cho 185-1, Nankoku, Kochi, 783-8505, Japan

    Kazuhiro Hanazaki

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  1. Masaki Yamamoto
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  2. Hitoshi Ninomiya
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  3. Miwa Tashiro
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  4. Takayuki Sato
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  5. Takemi Handa
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  6. Keiji Inoue
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  7. Kazumasa Orihashi
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  8. Kazuhiro Hanazaki
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Correspondence to Masaki Yamamoto.

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Electronic supplementary material

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10047_2018_1083_MOESM1_ESM.tif

Supplementary material 1 TICs described from graft no. 10. The TICs were measured from the graft and distal host artery. FLI: fluorescence luminance intensity (TIF 1655 KB)

Supplementary material 2 Near-infrared fluorescence angiographic image. The ICG opacification of the graft and posterior tibial artery (PTA) are shown (graft no. 1 of Table 2) (MPG 7836 KB)

Supplementary material 3 Near-infrared fluorescence angiographic image. The ICG opacification of the graft and posterior tibial artery (PTA) are shown (graft no. 8 of Table 2) (MPG 7460 KB)

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Yamamoto, M., Ninomiya, H., Tashiro, M. et al. Evaluation of graft anastomosis using time–intensity curves and quantitative near-infrared fluorescence angiography during peripheral arterial bypass grafting. J Artif Organs 22, 160–168 (2019). https://doi.org/10.1007/s10047-018-1083-9

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  • DOI: https://doi.org/10.1007/s10047-018-1083-9

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