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Updated: Jul 6, 2026
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Published on: July 24, 2019
Indocyanine Green Fluorescence Angiography to Assess Tissue Perfusion Before Common Femoral Artery Aneurysm Ligation
Steven J G Leeuwerke1,2, Harry G M Vaassen1,2, Robbert Meerwaldt1
1Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
Introduction:
The superiority of indocyanine green fluorescence angiography (ICG-FA) to the clinical eye alone to assess tissue perfusion has been demonstrated in various surgical fields. This short report demonstrates the in vivo use of ICG-FA to assess skin perfusion before ligating the external iliac artery (EIA) to exclude a common femoral artery (CFA) aneurysm.
Report:
A 70-year-old man presented with a CFA aneurysm after a previous transfemoral amputation. Ligation of the EIA was proposed, but concerns about tissue perfusion warranted a careful approach. The CFA was exposed using an infra-inguinal incision. Intra-operative ICG inflow and washout patterns were semi-quantitatively analysed to assess dermal perfusion of the femoral stump before and after EIA clamping. Based on similar patterns, distal EIA ligation was performed without ischaemic complications.
Conclusion:
Indocyanine green fluorescence angiography is a promising technique for in vivo assessment of tissue perfusion in peripheral arterial disease, but standardised protocols for perfusion quantification are required to more accurately predict tissue viability.
