Introduction: Intraoperative indocyanine green videoangiography (ICG-VA) has been widely used in vascular surgeries. Vessels are clearly shown as white in black background. However, we cannot observe the other structures during ICG-VA. We developed a new high-resolution intraoperative imaging system to simultaneously visualize both visible light color image and near-infrared (NIR) fluorescence image of ICG-VA.
Methods: The operative field was illuminated via an operating microscope by halogen and xenon lamps with a filter to eliminate wavelengths over 780 nm. In the camera unit, visible light was filtered to 400–700 nm and NIR fluorescence emission light was filtered to 800–900 nm using a special sensor unit with an optical filter. Light and NIR fluorescence images were simultaneously visualized on a single monitor.
Results: Our system clearly visualized the color operative field together with the enhanced blood flow. In aneurysm surgeries, clipping with neck remnant or remnant flow into the aneurysm was confirmed. In the cases of arteriovenous malformation, feeding arteries and draining veins were easily distingished.
Conclusions: Using our system, we can observe the color operative field and the enhanced blood flow by ICG in real-time. Our system could facilitate various types of vascular surgereis.
Patient Care: We can preserve the blood flow because our system simultaneously visualize the color operative field and the enhanced blood flow.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of preservation of the blood flow, 2) Discuss, in small groups,usefulness and limitation of the ICG-VA, 3) Identify an effective treatment using our system.