Efficacy of indocyanine green fluorescence in predicting parathyroid vascularization during thyroid surgery
Alexander C Razavi1,2, Kareem Ibraheem1, Antoine Haddad1
1Division of Endocrine and Oncologic Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
Background:
We examined the value of indocyanine green (ICG) fluorescence angiography in predicting parathyroid vascularization following thyroid and central compartment surgeries.
Methods:
Data were prospectively collected on adult patients undergoing thyroid and/or central compartment surgeries. Outcomes were compared in surgeries performed with and without ICG use. ICG scoring was used to quantify the vascularity of parathyroid glands.
Results:
One hundred eleven patients were included; 43 (38.7%) patients underwent ICG injections. There was no significant difference in mean parathyroid hormone (PTH) changes at the end of surgery (29.24 vs 23.48 pg/mL, P = .38), symptomatic hypocalcemia (7.9% vs 3.9%, P = .37), or length of stay (1.095 ± 0.22 vs 0.912 ± 0.07 days, P = .51) between surgeries performed with and without ICG. The average vascularization score among individuals undergoing ICG angiography was 2.89 out of a maximum of 8 points.
Conclusion:
Low-flow ICG patterns are not associated with postoperative PTH changes or transient hypocalcemia and may lead to unnecessary parathyroid autotransplantation.
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