Efficacy of indocyanine green fluorescence in predicting parathyroid vascularization during thyroid surgery
Alexander C. Razavi MPH  Kareem Ibraheem MD  Antoine Haddad MD  Lachin Saparova MD  Hosam Shalaby MD  Mohamed Abdelgawad MD, MD  Emad Kandil MD, MBA
First published: 17 June 2019 https://doi.org/10.1002/hed.25837
Research Presentations: The findings from this paper were presented as a poster presentation at the American Association of Endocrine Surgeons Annual Meeting, May 6‐8, 2018, Durham, North Carolina.
Funding information: Tulane Department of Surgery
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Abstract
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.