The impact of nitroglycerine and volume on gastric tube microperfusion assessed by indocyanine green fluorescence imaging.

The influence of hypervolemia and intraoperative administration of nitroglycerine on gastric tube microperfusion remains unclear The present study aimed to investigate the impact of different hemodynamic settings on gastric tube microperfusion quantified by fluorescence imaging with Indocyanine green (ICG-FI) as a promising tool for perfusion evaluation. Three groups with seven pigs each were formed using noradrenaline, nitroglycerin, and hypervolemia for hemodynamic management, respectively. ICG-FI, hemodynamic parameters, and transit-time flow measurement (TTFM) in the right gastroepiploic artery were continuously assessed.

Quantification of gastric tube perfusion following esophagectomy using fluorescence imaging with indocyanine green.

Introduction: Anastomotic leakage (AL) remains a prevalent and life-threatening complication after esophagectomy. Gastric tube perfusion assessment using indocyanine green fluorescence imaging (ICG-FI) has been published in several studies and appears to be a promising tool to reduce AL rates by changing the surgical approach, namely by an intraoperative evaluation of the anastomosis localization.

Methods: In this study, gastric tube perfusion was quantified by using ICG-FI in 20 high-risk patients undergoing esophagectomy.

Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.

Background: Mesenteric ischemia is a severe and potentially lethal event. Assessment of intestine perfusion is eminently depending on the skills, and the experience of the surgeon. Thus, the therapy is biased by the right evaluation.

Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model.

Objectives: Evaluation of intestinal perfusion remains subjective and depends on the surgeon´s individual experience. Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) fluorescence using a near-infrared camera system has been described in different ways and for different indications. The aim of the present study was to evaluate fluorescent imaging (FI) in the quantitative assessment of intestinal perfusion in a gastric tube model in pigs and to compare the results to results obtained with florescent microspheres (FM), the gold standard for tissue perfusion.

Generation of a high-resolution 3D-printed freeform collimator for VCSEL-based 3D-depth sensing.

This Letter discusses the generation of 3D-printed micro-optics to obtain the desired beam profile from a multimode vertical-cavity surface-emitting laser (VCSEL) with a significantly reduced divergence angle via the usage of high-resolution two-photon polymerization. Due to the low cost and compact packaging, the VCSEL array is a novel light source for structured-light projection. Particularly for long-distance 3D sensing applications, a greatly reduced divergence angle ensures that a good signal with a sufficiently large number of photons can be recorded, and the projected illumination spots do not overlap.

[Depth Effect of Cold Atmospheric Pressure Plasma in Keratitis Therapy: A Corneal Stroma Tissue Model].

The incidence of microbial keratitis has been increasing and is now 28 cases/100,000 inhabitants; this may be due to the more frequent use of contact lenses. Keratitis can lead to visual impairment and in severe cases with endophthalmitis to enucleation of the affected eye. As microorganisms are becoming more resistant to antibiotic therapy, there is a need for new therapeutic strategies.

[In Vitro Study of Subablative Er : YAG Laser and Diode Laser Therapy vs. Thermal Cautery in Microbial Keratitis].

Background: In microbial keratitis, thermal cautery leads to thermal necrosis associated with germ reduction. Subablative heating of the cornea using an Er : YAG laser or diode laser is an alternative option. Thermal effects and reproducibility of both procedures were investigated.

Qualitative angiographic and quantitative myocardial perfusion assessment using fluorescent cardiac imaging during graded coronary artery bypass stenosis.

Intraoperative graft assessment in coronary artery bypass (CAB) grafting is important to avoid early graft failure. This study aimed to evaluate the accuracy of fluorescent cardiac imaging (FCI) for intraoperative qualitative angiographic and quantitative myocardial perfusion assessment during graded CAB stenosis compared to coronary angiography (CA). After CAB grafting to the left anterior descending coronary artery, graded distal bypass stenoses were created in ten pigs by 25, 50, 75, and 100% flow reduction assessed by transit-time flow measurement (TTFM).

Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease.

Background: Perioperative evaluation in peripheral artery disease (PAD) by common vascular diagnostic tools is limited by open wounds, medial calcinosis or an altered collateral supply of the foot. Indocyanine green fluorescent imaging (ICG-FI) has recently been introduced as an alternative tool, but so far a standardized quantitative assessment of tissue perfusion in vascular surgery has not been performed for this purpose. The aim of this feasibility study was to investigate a new software for quantitative assessment of tissue perfusion in patients with PAD using indocyanine green fluorescent imaging (ICG-FI) before and after peripheral bypass grafting.

Distinction of non-ischemia inducing versus ischemia inducing coronary stenosis by fluorescent cardiac imaging.

Intraoperative fluorescent cardiac imaging (FCI) can quantitatively assess myocardial perfusion abnormalities produced by graded flow-limiting coronary stenosis (FLS), but there are no data to distinguish FLS from non flow-limiting stenosis (NFLS) to determine their functional significance. The aim of the study was to evaluate whether non-ischemia inducing NFLS can be quantified and differentiated from FLS by FCI technology. Data are compared to gold standard fluorescent microspheres (FM).

A phase IIA dose-finding study of PVP-hypericin fluorescence cystoscopy for detection of nonmuscle-invasive bladder cancer.

Purpose: To determine the optimum dosage and instillation time for water-soluble polyvinylpyrrolidone (PVP)-hypericin for photodynamic diagnosis of bladder cancer and to monitor its use in regard to patient safety.

Patients And Methods: Forty patients with a cystoscopically suspected bladder neoplasm were enrolled in this prospective phase IIA study. Different combinations of PVP-hypericin dosage (225 μg and 75 μg and instillation time (120, 60, 30, 15 min) were used to evaluate the optimal conditions.

Hemodynamic impact of transseptal access to the ascending aorta in a porcine model.

Purpose: To evaluate the hemodynamic impact of transseptal sheath access to the ascending aorta using increasing sheath diameters.

Methods: Transseptal puncture was performed in 6 pigs (62±9 kg) facilitating guidewire passage across the left heart to the descending aorta to establish transseptal through-and-through access into the ascending aorta. Hemodynamic parameters were evaluated during 6- to 16-F sheath deployments and after sheath retraction according to a standardized protocol.

Myeloperoxidase deficiency preserves vasomotor function in humans.

Aims: Observational studies have suggested a mechanistic link between the leucocyte-derived enzyme myeloperoxidase (MPO) and vasomotor function. Here, we tested whether MPO is systemically affecting vascular tone in humans.

Methods And Results: A total of 12 135 patients were screened for leucocyte peroxidase activity.

Thermal effects of white light illumination during microsurgery: clinical pilot study on the application safety of surgical microscopes.

Modern operating microscopes offer high power illumination to ensure optimal visualization, but can also cause thermal damage. The aim of our study is to quantify the thermal effects in vivo and discuss conditions for safe use. In a pilot study on volunteers, we measured the temperature at the skin surface during microscope illumination, including the influence of anaesthesia and the effects of staining, draping, or moistening of the skin.

Fluorescent cardiac imaging: a novel intraoperative method for quantitative assessment of myocardial perfusion during graded coronary artery stenosis.

Background: The purpose of the present study was to examine whether the effect of coronary stenoses of variable severity on myocardial perfusion can be quantitatively assessed in vivo by analysis of fluorescent cardiac imaging (FCI) compared with the gold standard, the fluorescent microsphere method. FCI is a novel technology to visualize coronary vessels and myocardial perfusion intraoperatively using the indocyanine green dye with an infrared-sensitive imaging device.

Methods And Results: Graded stenoses and total vessel occlusion of the left anterior descending coronary artery were created in 11 open-chest pigs.

Near-infrared fluorescence coronary angiography: a new noninvasive technology for intraoperative graft patency control.

Background: Intraoperative graft patency verification is of major clinical importance for quality control after coronary artery bypass grafting (CABG), especially if surgery is performed on the beating heart. This is one of the first reports of fluorescence coronary angiography (FCA) using the dye indocyanine green (ICG), a noninvasive technology for direct visualization of coronary arteries, bypass grafts, and myocardial perfusion.

Methods: Twenty-three domestic pigs (weight, 45-72 kg) underwent FCA of the left anterior descending coronary artery (LAD).