血流不全が疑われた指に対しインドシアニングリーン蛍光造影法による循環動態評価を行い救指しえた 1 例 Usefulness of Indocyanine Green ( ICG ) Angiography Imaging for Evaluating Impaired Digital Circulation
Recently, indocyanine green ( ICG ) fluorescence angiography imaging is often used in many kinds of surgical cases for a variety of purposes, but it is rarely used to evaluate digital blood flow. In this report, we demonstrate the usefulness of ICG fluorescence for evaluation of blood flow in a case of impaired digital circulation in a 31-year old man. The impaired circulation occurred during revision surgery for multiple finger amputation injury. Although it was difficult to judge the need for immediate revascularization, we could diagnose the clinical blood flow condition by ICG fluorescence. As a result, emergency surgery for revascularization was performed, and the finger was saved. Conventional methods for evaluation of finger blood flow require comprehensive judgement based on many clinical factors, such as skin color, skin temperature, elasticity, capillary refilling, and the pin prick test, but this comprehensive judgment is sometimes difficult because it is impossible to quantify these clinical findings. ICG fluorescence can visualize blood flow directly, which gives it an advantage over other visualization methods. However, because ICG infusion is invasive, its use for monitoring blood flow should be limited. In addition, when we evaluate finger blood flow, the affected limb should be kept elevated.
日本マイクロサージャリー学会会誌 30(2), 69-74, 2017