title: Visualization of bronchial circulation at bronchial anastomotic site using bronchial fluorescein angiography technique.
abstract: Successful bronchial healing after a bronchoplastic procedure mainly depends on bronchial circulation at the anastomostic site. We developed a bronchial fluorescein angiography (B-FAG) technique for visualizing circulation on the bronchial surface. The technique was evaluated in animals.
  
  
  
  Fluorescein was used as a contrast agent and an autofluorescence imaging (AFI) bronchoscope as a detector. The left main pulmonary artery (PA) and main bronchus of 10 pigs were isolated. After transection of the left main bronchus and bronchial arteries and re-anastomosis of the bronchus, the pigs were randomly divided into two groups: the PA- group (n = 5), in which the pulmonary artery was transected; and the PA+ group (n = 5), in which the pulmonary artery was preserved. Following intravenous injection of fluorescein, the distal anastomotic site was observed for 30 min with autofluorescence imaging bronchoscopy. Bronchial specimens sampled 2 days after the surgical intervention were histologically evaluated.
  
  
  
  In the PA- group, there was no fluorescein enhancement in the distal bronchus throughout the observation time. However, enhancement, which turned the bronchial surface from magenta to bright green, was clearly observed in less than 207 ± 102.5 s in the PA+ group. The enhancement status detected by bronchial fluorescein angiography was related to the extent of tissue damage, as was proven histologically in the acute healing stage.
  
  
  
  Bronchial fluorescein angiography clearly visualized the circulatory status promptly after the anastomosis procedure at the central bronchus. This technique is a potentially practical approach to predict ischaemic airway complications following bronchial anastomosis.
authors.affiliation: Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Norichika
authors.initials: N
authors.lastname: Iga
authors.affiliation: Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan kmiyoshi@okayama-u.ac.jp kentarohmiyoshi@yahoo.co.jp.
authors.forename: Kentaroh
authors.initials: K
authors.lastname: Miyoshi
authors.affiliation: Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Takata
authors.affiliation: Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirano
authors.affiliation: Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Konishi
authors.affiliation: Organ Transplant Center, Okayama University Hospital, Okayama, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Otani
authors.affiliation: Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Sugimoto
authors.affiliation: Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamane
authors.affiliation: Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
authors.affiliation: Organ Transplant Center, Okayama University Hospital, Okayama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oto
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001980:Bronchi / Q000601:surgery*; D001981:Bronchial Arteries / Q000000981:diagnostic imaging* / Q000601:surgery; D001999:Bronchoscopy; D005451:Fluorescein Angiography; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D011652:Pulmonary Circulation; D011897:Random Allocation; D013552:Swine; D014945:Wound Healing
keywords: Airway complication; Autofluorescence imaging; Bronchoplasty; Bronchoscopy