Yamamoto Masaki, Nishimori Hideaki, Handa Takemi, Fukutomi Takashi, Kihara Kazuki, Tashiro Miwa, Sato Takayuki, Orihashi Kazumasa
Departments of Surgery II and Cardiovascular Control, Kochi Medical School, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan.
Surg Today. 2017 Feb;47(2):210-217. doi: 10.1007/s00595-016-1369-6. Epub 2016 Jun 28.
The HyperEye Medical System (HEMS) uses indocyanine green (ICG) to visualize blood vessels in coronary artery bypass grafting (CABG). We performed quantitative HEMS assessment to detect grafts at risk of occlusion.
We assessed the HEMS angiograms of 177 grafts from 69 patients who underwent CABG and compared the results with those of fluoroscopic coronary angiography, by measuring the increasing rate of ICG intensity, average acceleration value, and time to peak luminance intensity.
Grafts in the patent and failed groups showed significant differences in their increasing rate of intensity and average acceleration value. The average accelerations value of ICG intensity of internal thoracic artery (ITA) and saphenous vein (SV) grafts were 112.3 and 144.9 intensity/s in the patent group, and 71.0 and 91.8 intensity/s in the failed group. The time to peak luminance intensity was 1.7 and 1.4 s in the patent group and 2.3 and 1.9 s in the failed group; these values were not significantly different.
Significant reductions in the ICG intensity rate and average acceleration value can occur in failed grafts. Therefore, quantifiable changes in ICG intensity may help detect minute changes in blood flow.
HyperEye医疗系统（HEMS）使用吲哚菁绿（ICG）来可视化冠状动脉旁路移植术（CABG）中的血管。我们进行了HEMS定量评估以检测有闭塞风险的移植物。
我们评估了69例行CABG患者的177个移植物的HEMS血管造影，并通过测量ICG强度增加率、平均加速度值和达到峰值亮度强度的时间，将结果与荧光冠状动脉造影结果进行比较。
通畅组和失败组的移植物在强度增加率和平均加速度值方面存在显著差异。在通畅组中，胸廓内动脉（ITA）和大隐静脉（SV）移植物的ICG强度平均加速度值分别为112.3和144.9强度/秒，在失败组中分别为71.0和91.8强度/秒。在通畅组中达到峰值亮度强度的时间为1.7和1.4秒，在失败组中为2.3和1.9秒；这些值无显著差异。
失败的移植物中ICG强度率和平均加速度值可能会显著降低。因此，ICG强度的可量化变化可能有助于检测血流的微小变化。
