title: [Visualization of the distal edge of carotid plaque using indocyanine green videoangiography during carotid endarterectomy and the pitfall involved].
abstract: OBJECTIVE
  Microscope-integrated near-infrared indocyanine green video angiography (ICG-VA) is a new method of intraoperative blood flow assessment. The objective of this study was to evaluate the efficacy of ICG-VA in carotid endarterectomy to visualize the carotid plaque area, especially the distal end.
  
  
  METHODS
  Twenty patients who underwent carotid endarterectomy were included. Before arteriotomy and after vessel closure, ICG was injected intravenously. The plaque area and patency of the carotid artery were assessed.
  
  
  RESULTS
  In all cases, the distal end of the carotid plaque was identified and the patency of the internal carotid artery was confirmed after excision of plaque. In seventeen cases (85.0%), the proximal end was also identified. The internal surface of carotid plaque was not seen. Some images show reflux of contrast medium into the internal jugular after a left-arm injection.
  
  
  CONCLUSIONS
  ICG-VA provides real-time information on the carotid plaque area and the patency of arterial vessel during surgical procedure. It is necessary to pay special attention to injection routes, existence of any foreign body and the influence of hemostasis in order to get better contrast. ICD-VA would be a useful adjunct to improve the quality of CEA.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Okawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Abe
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hirata
authors.forename: Koichiro
authors.initials: K
authors.lastname: Takemoto
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Iwaasa
authors.forename: Toshio
authors.initials: T
authors.lastname: Higashi
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D016894:Endarterectomy, Carotid / Q000379:methods*; D006487:Hemostasis; D006801:Humans; D007208:Indocyanine Green; D007432:Intraoperative Period; D014654:Vascular Patency; D014741:Video Recording
chemical_list: D007208:Indocyanine Green