Intraoperative Angiography Guided by Indocyanine Green (ICG)

Intraoperative angiography guided by Indocyanine Green (ICG) is an advanced imaging modality becoming increasingly prevalent in surgical practice, particularly within hepatobiliary (liver) and gastrointestinal surgeries. This technique enables the surgeon to visualize tissue perfusion and blood flow in real time during the procedure, thereby ensuring safer and more effective surgical outcomes.

What is ICG?

ICG is a specialized fluorescent dye that binds to plasma proteins upon intravenous injection, allowing for the precise tracking of intravascular blood flow. Because it fluoresces under near-infrared (NIR) light, it illuminates blood vessels with high contrast, distinguishing them clearly from surrounding non-vascular structures.

What is Intraoperative Angiography?

Intraoperative angiography is a method utilized to image vascular structures in real time during a surgical procedure. While conventional angiography relies on standard radiographic contrast media and fluoroscopy, the integration of ICG allows this process to be completed more rapidly, safely, and without exposure to ionizing radiation.

Clinical Advantages of ICG-Guided Intraoperative Angiography

• Real-Time Visualization of Blood Flow: The surgeon can continuously monitor vascular perfusion and anastomotic viability during the operation, enabling the immediate detection and control of active hemorrhage.
• Reduced Intraoperative Hemorrhage: Enhanced visualization of the micro- and macro-vasculature significantly minimizes the risk of accidental vascular injury and unwanted bleeding.
• Precise Tissue Differentiation: It aids in delineating anatomical planes and differentiating healthy parenchyma from hypoperfused or neoplastic (cancerous) tissues, ensuring a more precise oncological resection.
• Optimized Operative Time: Streamlining vascular identification can shorten the overall duration of the surgery, resulting in less surgical trauma and anesthesia exposure for the patient.
• Decreased Post-Operative Complications: It significantly mitigates the risk of severe post-operative complications, such as anastomotic leaks, ischemic necrosis, hemorrhage, and subsequent surgical site infections.