Indocyanine Green-Guided Pulmonary Resection for Lung Cancer With Anomalous Systemic Arterial Supply to the Basal Segment

Abstract

A 78-year-old male who was undergoing treatment for diabetes was referred to our department after a chest X-ray revealed an abnormal shadow in the left upper lung field. A chest contrast-enhanced CT showed a tumor in the left upper lobe and a cystic lesion in the left lower lobe. Two aberrant arteries branching from the aorta were identified near the cyst. The patient was diagnosed with lung cancer and anomalous systemic arterial supply to the basal segment of the left lung (ABLL), necessitating surgical intervention. Thoracoscopic surgery was performed, with the left upper segmentectomy guided by Indocyanine green (ICG) to facilitate precise intersegmental plane identification. The two aberrant arteries were resected, and the perfusion area supplied by these arteries was excised using repeated ICG intravenous injection. This case of lung cancer with ABLL demonstrates that the repeated use of ICG can enable not only a precise upper segmentectomy but also accurate visualization and resection of a perfusion area supplied by aberrant arteries.