title: Visualization of declamping procedure during carotid endarterectomy by ICG videoangiography.
abstract: BACKGROUND
  ICG videoangiography (ICG-VAG) is widely used in neurovascular surgery. In carotid artery disease, it has been used to assess the extent of the plaque and to confirm the removal of the plaque and patency of the artery. We introduce a novel usage of the ICG-VAG to confirm the patency of the external carotid artery (ECA) and superior thyroid artery (STA), which should work as a drainage system of possible debris in the lumen.
  
  
  METHODS
  Consecutive 27 patients with severe internal carotid artery stenosis were employed. Carotid endarterectomy (CEA) was done in the usual fashion. After suturing the arteriotomy, ICG was injected intravenously before reperfusion. Before declamping procedure, ICG-VAG mode was started. As the declamping procedure went on, the assistant judged whether the STA and the ECA were patent by watching the ICG flow on the monitor. After confirming the patency of the ECA-CCA system, the ICA was reperfused.
  
  
  RESULTS
  The back flow from the STA was not confirmed in two cases. The back flow from the ECA was confirmed in all 27 cases. In four cases, the ICG-VAG showed air bubbles in the lumen; these bubbles were washed away to the ECA or STA.
  
  
  CONCLUSIONS
  Using ICG-VAG during the reperfusion procedure of CEA, the patency of the ECA and the STA can be confirmed. It may contribute to reduce embolic complication during reperfusion procedure.
authors.affiliation: a Department of Neurosurgery , NTT Medical Center , Tokyo , Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kimura
authors.affiliation: a Department of Neurosurgery , NTT Medical Center , Tokyo , Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Kidani
authors.affiliation: a Department of Neurosurgery , NTT Medical Center , Tokyo , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ibayashi
authors.affiliation: a Department of Neurosurgery , NTT Medical Center , Tokyo , Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kawai
mesh_terms: D000328:Adult; D002342:Carotid Artery, External / Q000033:anatomy & histology / Q000601:surgery; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods*; D002536:Cerebral Arteries / Q000601:surgery; D015331:Cohort Studies; D004396:Coloring Agents; D003250:Constriction; D004322:Drainage; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D020766:Intracranial Embolism / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D014741:Video Recording
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: ICG videoangiography; carotid endarterectomy; embolic complication