Abstract
Vascular grafting failures are often attributed to inadequate anastomotic perfusion assessments. If successful, vascular anastomosis can be rapidly confirmed through the visualization of continuous blood flow upon completion of the grafting process. Surgeons can then minimize graft failures, thus decreasing morbidity in a cost-effective manner. Fluorescence image-guided surgery using near-infrared (NIR) dye is one of the methods that can be performed to monitor grafting success. To address the current logistical challenges and costs of these systems, a compact camera system was used for intraoperative fluorescence real-time NIR imaging. Combined with benchtop experiments, a swine model was used to demonstrate the procedure of using a near-infrared navigation system (NAVI) to visualize grafted vessels in vivo. This was done by performing bilateral arteriovenous grafts and imaging intravenously injected ICG as it circulated through the grafted vessels. The fluorescent images obtained by NAVI were corroborated with Doppler flow measurements and cine-angiography, the current gold standard for the evaluation of vascular grafts.
