Indocyanine green fluorescence-guided parathyroidectomy for primary hyperparathyroidism.
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| Abstract | BACKGROUND: Our aim was to evaluate the ease and utility of using indocyanine green fluorescence angiography for intraoperative localization of the parathyroid glands. METHODS:
Indocyanine green fluorescence angiography was performed during 60 parathyroidectomies for primary hyperparathyroidism during a 22-month period. Indocyanine green was administered intravenously to guide operative navigation using a commercially available fluorescence imaging system. Video files were graded by 3 independent surgeons for strength of enhancement using an adapted numeric scoring system. RESULTS: There were 46 (77%) female patients and 14 (23%) male patients whose ages ranged from 17 to 87 (average 60) years old. Of the 60 patients, 43 (71.6%) showed strong enhancement, 13 (21.7%) demonstrated mild to moderate vascular enhancement, and 4 (6.7%) exhibited little or no vascular enhancement. Of the 54 patients who had a preoperative sestamibi scan, a parathyroid adenoma was identified in 36, while 18 failed to localize. Of the 18 patients who failed to localize, all 18 patients (100%) had an adenoma that fluoresced on indocyanine green imaging. The operations were performed safely with minimal blood loss and short operative times. CONCLUSION:
Indocyanine green angiography has the potential to assist surgeons in identifying parathyroid glands rapidly with minimal risk.
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| Authors | Jonathan C DeLong, Erin P Ward, Thinzar M Lwin, Kevin T Brumund, Kaitlyn J Kelly, Santiago Horgan, Michael Bouvet |
| Journal | Surgery (Surgery) Vol. 163 Issue 2 Pg. 388-392 (02 2018) ISSN: 1532-7361 [Electronic] United States |
| PMID | 29129358 (Publication Type: Journal Article) |
| Copyright | Copyright © 2017 Elsevier Inc. All rights reserved. |
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