A novel infrared fluorescence method to identify regions of superficial microvenous reflux in patients with chronic venous disease

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of vascular surgery. Venous and lymphatic disorders Pub Date : 2026-05-01 Epub Date: 2026-01-19 DOI:10.1016/j.jvsv.2026.102448

Gregory T. Jones PhD, Kari Clifford PhD, Geraldine B. Hill MSc, Kate N. Thomas PhD, Sarah Lesche MD, Jolanta Krysa MBChB

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引用次数: 0

Abstract

Objective

Reflux within the superficial microvenous network may play a critical role in the development of skin changes associated with chronic venous insufficiency. This study aimed to extend previous ex vivo observations to determine the in vivo utility of near infrared fluorescence (NIRF) imaging to assess superficial venous reflux in the leg.

Methods

A total of 28 limbs were examined in 17 participants. These included limbs with (CEAP C2, n = 6; C3, n = 1; and C4, n = 15) and without (CEAP C0, n = 6) venous disease. Indocyanine green (5 mL at 0.1 mg/mL) was infused via an (antegrade) cannula in the distal great saphenous vein and the medial leg imaged using NIRF. Venous reflux was assessed using the Valsalva maneuver, with or without superficial outflow obstruction (thigh cuff inflated to 50 mmHg).

Results

Consistent with our previous ex vivo study, NIRF imaging visualized a wide range of different microvenous reflux patterns in vivo. These included focal and diffuse regions of fluorescence within the skin, the extent of which appeared to be associated with venous disease (CEAP C classification) severity. The observed reflux patterns also appeared to be functional correlates of perforator vein or saphenofemoral junctional incompetence.

Conclusions

This preliminary in vivo study provides proof-of-principle observations suggesting a potential novel method for investigating microvenous reflux in superficial venous disease.

Clinical Relevance

This study reports the first in vivo use of near-infrared fluorescence (NIRF) imaging with indocyanine green to assess superficial microvenous reflux within intact limbs. This preliminary data suggests that the extent and distribution of skin fluorescence may be associated with venous disease severity (CEAP Clinical classification). It also provides potential mechanistic insight, identifying reflux patterns that appear to be functional correlates of venous incompetence. This study suggests that NIRF imaging could provide a novel tool for investigating microvenous contributions to chronic venous disease and its skin manifestations.

查看原文本刊更多论文

一种新的红外荧光方法识别慢性静脉疾病患者浅表微静脉回流区域。

目的：浅表微静脉网络内的反流可能在慢性静脉功能不全相关皮肤变化的发展中起关键作用。本研究旨在扩展先前的离体观察，以确定近红外荧光（NIRF）成像在体内评估腿部浅表静脉回流的效用。方法：对17例患者共28条肢体进行检查。这些包括患有（CEAP C2 n=6, C3 n=1和C4 n=15）和没有（CEAP C0, n=6）静脉疾病的肢体。吲哚菁绿（5mL @ 0.1mg/mL）通过远端大隐静脉（顺行）插管输注，并使用NIRF对小腿内侧进行成像。采用Valsalva手法评估静脉回流，有无浅表流出物阻塞（大腿袖膨胀至50mmHg）。结果：与我们之前的离体研究一致，NIRF成像在体内显示了各种不同的微静脉反流模式。这些包括皮肤内荧光的局灶区和弥漫性区域，其程度似乎与静脉疾病（CEAP C分类）的严重程度有关。观察到的反流模式似乎也与穿支静脉或隐股关节功能不全有关。结论：这项初步的体内研究提供了原则性的观察结果，为研究浅表静脉疾病的微静脉回流提供了一种潜在的新方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of vascular surgery. Venous and lymphatic disorders SURGERYPERIPHERAL VASCULAR DISEASE&n-PERIPHERAL VASCULAR DISEASE

CiteScore

6.30

自引率

18.80%

发文量

328

审稿时长

71 days

期刊介绍： Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.