Case report: video-assisted thoracoscopic surgery for pulmonary arteriovenous malformation using near-infrared fluorescence with indocyanine green

Journal of Cardiothoracic Surgery

Case Report

Jian Gao¹  Tianxiao Han¹  Zhenfan Wang¹  Jian Zhou¹ 

[1] Department of Thoracic Surgery, Thoracic Oncology Institute, Peking University People’s Hospital, Beijing, China;

关键词: Indocyanine Green;    Near-infrared fluorescence;    Pulmonary arteriovenous malformation;   

DOI  :  10.1186/s13019-023-02351-w

 received in 2022-11-07, accepted in 2023-08-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPulmonary arteriovenous malformation (PAVM) is an abnormal communication between pulmonary vasculatures and has an unclear boundary with surrounding lung tissues. At present, surgeons can only determine its location by preoperative imaging and intraoperative palpation, despite its soft texture. Indocyanine green(ICG), a near-infrared fluorophore, has been demonstrated useful in the accurate identification of vascular tissue. Therefore, we explored its application in PAVM cases.Case presentationWe present two PAVM cases using near-infrared fluorescence (NIF) with 25 mg ICG at 5 mg/ml to achieve intraoperative visualization of the lesion in video-assisted thoracoscopic surgery (VATS). Under the NIF mode, ICG systemic injection led to successive signaling of the anomaly and normal tissues in merely 10 s, which helped us distinguish them efficiently and precisely. A peak signal-to-background ratio of 2.2 confirmed the significant fluorescence difference and excluded interference from carbon dust.ConclusionsWe are the first to report the use of such an approach in delineating the margin of vascular malformation with high contrast, and this new finding may help minimize the damage to lung function in PAVM treatment. Further exploration and validation are needed to determine its role.

【 授权许可】

CC BY   
© The Author(s) 2023

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