Document Detail


New fluorescence endoscope for use in twin-twin transfusion syndrome: In vivo visualization of placental blood vessels.
MedLine Citation:
PMID:  21146441     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Twin-twin transfusion syndrome (TTTS) is a condition in which twins share blood disproportionately by the communicating vessels in the shared placenta, resulting in high fetal and perinatal mortality. Fetoscopic laser photocoagulation is performed to interrupt these communicating vessels; however, small vessels are often missed due to the poor image obtained with a fetoscope. We have developed a fluorescence endoscope capable of visualizing very small vessels, even in amniotic fluid, and we investigated its feasibility for in vivo visualization of placental vessels. Indocyanine green (ICG) was given at single doses of 0.5, 1.0, and 1.5mg/kg, respectively, into the maternal circulation of pregnant rabbits, and the endoscope was used to identify the placental vessels. The vessels were detected within 15s after ICG injection for about 10min. The brightness difference between the intervillous space and the umbilical vessels was significantly smaller after administration of 0.5mg/kg than after 1.0mg/kg (p=0.02) or 1.5mg/kg (p=0.01). Even very small vessels (0.2mm in diameter) were detected. In conclusion, our new endoscope successfully provided a detailed view of the placental vessels in vivo. The results are promising for future TTTS laser surgery.
Authors:
Akihiko Ishiyama; Keri Kim; Hiromasa Yamashita; Yoshitaka Miyamoto; Shin Enosawa; Toshio Chiba
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-9
Journal Detail:
Title:  Medical engineering & physics     Volume:  -     ISSN:  1873-4030     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422753     Medline TA:  Med Eng Phys     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan.
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