A Case of Anastomotic Stenosis of a Peripheral Arterial Bypass Graft Undetected in Indocyanine Green Angiography

Masaki Yamamoto; Hitoshi Ninomiya; Miwa Tashiro; Hideaki Nishimori; Keiji Inoue; Takayuki Sato; Kazuhiro Hanazaki; Kazumasa Orihashi

doi:10.3400/avd.cr.17-00122

CASE REPORTS

A Case of Anastomotic Stenosis of a Peripheral Arterial Bypass Graft Undetected in Indocyanine Green Angiography

Masaki Yamamoto , Hitoshi Ninomiya, Miwa Tashiro, Hideaki Nishimori, Keiji Inoue, Takayuki Sato, Kazuhiro Hanazaki, Kazumasa Orihashi

Author information

Masaki Yamamoto Corresponding author
Department of Operating Management, Kochi Medical School, Kochi University
Department of Surgery 2, Kochi Medical School, Kochi University
Center for Photodynamic Medicine, Kochi Medical School, Kochi University
Hitoshi Ninomiya
Integrated Centre for Advanced Medical Technologies, Kochi Medical School, Kochi University
Miwa Tashiro
Department of Surgery 2, Kochi Medical School, Kochi University
Hideaki Nishimori
Department of Surgery 2, Kochi Medical School, Kochi University
Keiji Inoue
Center for Photodynamic Medicine, Kochi Medical School, Kochi University
Department of Urology, Kochi Medical School, Kochi University
Takayuki Sato
Center for Photodynamic Medicine, Kochi Medical School, Kochi University
Department of Cardiovascular Control, Kochi Medical School, Kochi University
Kazuhiro Hanazaki
Department of Operating Management, Kochi Medical School, Kochi University
Center for Photodynamic Medicine, Kochi Medical School, Kochi University
Department of Surgery 1, Kochi Medical School, Kochi University
Kazumasa Orihashi
Department of Surgery 2, Kochi Medical School, Kochi University
Center for Photodynamic Medicine, Kochi Medical School, Kochi University

Keywords: indocyanine green angiography, bypass grafting, peripheral arterial disease

JOURNAL OPEN ACCESS
Supplementary material

2018 Volume 11 Issue 2 Pages 233-235

DOI https://doi.org/10.3400/avd.cr.17-00122

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Abstract

We report the case of a 75-year-old man who underwent right femoral-popliteal bypass surgery. Anastomotic stenosis was overlooked in indocyanine green (ICG) angiography due to opacification on the bypass graft. X-ray angiography revealed slit-shaped stenosis in the distal graft anastomosis that required revision. Although blood flow may be maintained despite of anastomotic stenosis, small decreases in blood flow cannot be detected in ICG angiography. We describe and discuss the pitfalls of qualitative graft assessment using ICG angiography, and compare ICG fluorescence luminance intensity between primary and revised grafts.

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