Validation of IC-VIEW fluorescence videography in a rabbit model of mesenteric ischaemia and reperfusion.
OBJECTIVE
Mortality in mesenteric ischaemia can be reduced by an optimised extent of resection. Up to now, no technique supplementing a surgeon's experience has achieved clinical acceptance. Besides a qualitative interpretation, the new technique of computer-assisted laser-fluorescence videography affords quantification of staining intensities. The aim of this study was to investigate the scientific value of this technique in mesenteric ischaemia in a rabbit model of controlled mesenteric ischaemia and reperfusion.


METHODS
We used an established rabbit model of mesenteric ischaemia (group I, n=6) and reperfusion (group II, n=6). In each animal, three loops (each of 10 cm) of the small intestine were clamped (group I, 40 min; group II, 60 and 20 min reperfusion). For further evaluation, all loops were divided into five segments of 2 x 2 cm (total number of investigated areas, n=180). Measurement of vascular patency was performed by laser-fluorescence videography (pixel intensity per second). As standard, we used radioactive microspheres (impulse per minute per gram). In addition, the extent of ischaemic tissue damage was identified by histological examination. Statistical data were analysed by using regression analysis to define the regression coefficient r.


RESULTS
Laser-fluorescence videography and the microsphere technique demonstrated a close and linear correlation: ischaemic segments, r=0.90+/-0.07; reperfusion segments, r=0.85+/-0.02; overall, r=0.92+/-0.07. There was no reproducible correlation to cellular damage in histology.


CONCLUSIONS
Computer-assisted laser-fluorescence videography is a feasible, reliable, and valid experimental method for the detection of mesenteric blood supply and intestinal microcirculation. Clinical application is conceivable in mesenteric ischaemia and infarction as well as the operative transposition of intestine. As limiting values to identify the irreversible necrosis are not yet defined, further studies have to analyse the clinical impact more precisely.
Toens
C
C
Department of Surgery, Marienhospital, Düsseldorf, Germany.
Krones
C J
CJ
Blum
U
U
Fernandez
V
V
Grommes
J
J
Hoelzl
F
F
Stumpf
M
M
Klinge
U
U
Schumpelick
V
V
D000818:Animals; D002565:Cerium Radioisotopes; D004396:Coloring Agents; D004195:Disease Models, Animal; D005453:Fluorescence; D007091:Image Processing, Computer-Assisted; D007208:Indocyanine Green; D007511:Ischemia / Q000473:pathology*; D007834:Lasers; D008643:Mesentery / Q000098:blood supply* / Q000473:pathology*; D008833:Microcirculation; D008853:Microscopy; D008863:Microspheres; D011817:Rabbits; D015424:Reperfusion; D014741:Video Recording
D002565:Cerium Radioisotopes; D004396:Coloring Agents; D007208:Indocyanine Green