Near-infrared fluorescence venography: a navigation system for varicose surgery

Successful varicose vein surgery depends on accurate assessment and identification of veins. We report clinical experiences with a simple, rapid method of detecting varicose veins using indocyanine green (ICG) fluorescence video venography.

ICG percutaneously injected into the great saphenous vein at the ankle or into the ligated end of veins in 20 patients with varicose veins was used as the optical tracer agent. Intraoperative ICG imaging was performed using a laser-fluorescence imaging device.

ICG fluorescence venography was performed without any adverse effects. The imaging device provides unparalleled visualization of varicose veins during vein ligation, phlebectomy, and stripping.

This method enabled easy, safe, and accurate diagnoses, simplified the search for veins during the operation, and minimized surgical invasiveness in varicose vein surgery. The system has great potential as a navigational technique for phlebologic diagnosis and treatment of varicose veins. Further research and development to improve its utility are suggested.