1. National Cheng-Kung University, Medical College and Hospital
The Utility of Indocyanine Green Angiography for The Viability of Parathyroid Glands during Thyroidectomy ---Primitive Report
Shih-Ming Huang M.D
Department of Surgery
National Cheng-Kung University, Medical College and Hospital

2. Background & Purpose Indocyanine green (ICG)---Mechanism
1) Liver function
2) Biliary tree image
3) Sentinel lymph nodes
4) Angiography---a) Colon anastomosis
b) Tissue perfusion Parathyroid gland-- ICG angiography
a)Vascularity Endocrine
b)Viability----S/P Thyroidectomy

3. ICG binds to plasma protein Absorption 805nm, re-emission 835nm

4. Biliary tree GI Tract

5. Background & Purpose Indocyanine green (ICG)---Mechanism
1) Liver function
2) Biliary tree image
3) Sentinel lymph nodes
4) Angiography---a) Colon anastomosis
b) Tissue perfusion Parathyroid gland-- ICG angiography
a)Vascularity Endocrine
b)Viability----S/P Thyroidectomy

6. METHODS (50 GLANDS)
ICG --25mg / 10ml distilled water), 3.3 ml iv Near-infrared machine 1) perfusion angiography 2) tissue staining Repeated injection min. parathyroid gland Vascularized staining Vs Eye . If 1) Poor perfusion ICG , 2) congestion or 3)discordance Partial cutting --- Bleeding & repeated ICG

7. 2 minutes No(-) ,Question(-), Ok(+)

8. Parathyroid tumor

10. (++)43
(++)1
3(+ -)
(--)2
(- -)3
(+-)1

11. CONCLUSIONS:
Intraoperative ICG angiography of parathyroid during thyroidectomy:
1)Confirming the viability by naked eye observation, and
2) Further Mx -- questionable viable gland.

12. Thanks very much for
Your Attention