Fluorescence In Vivo Endomicroscopy


Figure 8: In vivo FIVE fluorescein imaging of blood vessels from swine brain surface. Visualization of the functional state of brain microvasculature in swine. (A) After the clipping of the artery (200–250 µm diameter) proximally (clip on), immediate slowing of the blood flow is observed distally. After the clip is removed (clip off), the restoration of arterial flow pattern is noted. These findings are consistent with repetitive clip application and removal (1min) in 3 animals. (B) Dynamics of the intraluminal agglutination and thrombi formation in the microvasculature are consistently observed during cardiac arrest at the termination of surgery in all animals. (C) Some collaterals are not functionally active and have stagnant flow (short yellow arrows point to the resting cells in the capillary; long white arrow shows direction of the preserved flow). (D) Constriction (short white arrows) and partial thrombosis of the vessel observed at the area of surgical trauma. The series of images dem- onstrates that part of the vessel has a normal flow (curved yellow arrow), while part of a vessel has a turbulent flow (curved white arrow) with only a few agglutinated blood cells. (E) Topmost panel shows the cortical microvasculature in the area of cortical injury (cold injury), outlined by the dashed line. In the second panel from the top, a Yellow 560 fluorescent image obtained during the arterial phase shows gross appearance of fluorescein extravasation into the brain tissue. FIVE imaging of the area in the square inset in the right corner is shown in the panel below. In the bottom panel, FIVE shows intraluminal thrombosis in the venules and cell adhesion to the vascular wall (white arrows). Findings are consistent and are observed similarly in areas of cold injury (repeated in 3 animals) and areas of unintentional surgical injury to cortex due to craniotomy (observed in all 5 animals). (F) FIVE images showing uninjured (left panels) and injured (right panels) spinal cord. Normal microvasculature in the spinal cord shows elongated vessels with branches and competent blood-brain barrier preventing contrast extravasation. Multiple extravascular blood cells and extravasation of the contrast are observed at the region of the spinal cord injury. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.


22 www.microscopy-today.com • 2021 May


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