How does ICG work?

ICG is a tricarbocyanine dye which fluoresces, i.e. emits light, after excitation under near-infrared light at 806 nm light. ICG is highly soluble in water and binds to β-lipoproteins, particularly to albumin. Because of the high protein content of lymph, ICG accumulates in the lymphatic pathways and lymph nodes.

How long does indocyanine green stay in your system?

Because of the plasma protein binding, ICG stays for up to 20 to 30 minutes in the vessels (intravasally). When the eye is examined, it thus stays for a long time in tissues with a higher blood flow, such as the choroid and the blood vessels of the retina.

Is there iodine in ICG?

ICG contains sodium iodide and, according to the manufacturer, it should be used with caution in patients who have a history of allergy to iodides because of the risk of anaphylaxis.

How do you dilute indocyanine green?

For visualization of vessels, blood flow, tissue perfusion, and extrahepatic biliary ducts, dilute 25 mg indocyanine green with 10 mL of Sterile Water for Injection (2.5 mg/mL). For ophthalmic angiograms, dilute up to 40 mg indocyanine green with 2 mL of Sterile Water for Injection (up to 20 mg/mL).

When do you give ICG?

Our results indicated that ICG is best administered at 15 h. Based on contrast‐to‐background ratios, the timing of preoperative administration was best at 15 h before surgery. For the visibility, the timing of preoperative administration was also best at 15 h before surgery.

What is cholecystectomy with ICG?

Intraoperative cholangiography involving the excretion of fluorescent indocyanine green (ICG) into the bile is used to determine biliary anatomy in laparoscopic cholecystectomy (LC).

When was ICG FDA approved?

ICG was developed well before the era of infrared imaging in the Second World War, and was granted FDA approval in 1959.