Functional Capillary Density for in Vivo Estimation of Intestinal Perfusion using Real-Time Confocal EndomicroscopyLuigi Schiraldi1, Francesco Marchegiani1, Michele Diana1,2*, Véronique Lindner3, Eric Noll4, Pierre Diemunsch4 and Jacques Marescaux1,2
- *Corresponding Author:
- Michele Diana
place de l’Hôpital 67091
Tel: +33 651 186 529
Fax: +33 388 119 099
E-mail: [email protected]
Received date: May 22, 2015 Accepted date:June 22, 2015 Published date: June 24, 2015
Citation: Schiraldi L, Marchegiani F, Diana M, Lindner V, Noll E, et al. (2015) Functional Capillary Density for in Vivo Estimation of Intestinal Perfusion using Real-Time Confocal Endomicroscopy. J Cytol Histol 6:334. doi:10.4172/2157-7099.1000334
Copyright: © 2015 Schiraldi L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background and aim: Confocal Laser Endomicroscopy (CLE) has been successfully used to appreciate microcirculation changes of the digestive mucosa. Our aim was to evaluate CLE scanning complemented by functional capillary density area (FCD-A) estimation to define the micro-vessel status in a reiterate, long-lasting porcine model of bowel ischemia.
Materials and methods: A laparotomy was performed in 4 pigs, and a segmental (3–4 cm) ischemia of the sigmoid colon was induced with vascular clamps. Ischemic and perfused regions were clinically defined. After an injection of 5 ml of sodium fluorescein 10% (Fluocyne, SERB, Paris, France), the Cellvizio™ confocal probe (Mauna Kea Technologies, Paris, France) was directly applied onto the mucosa’s surface through a full-thickness enterotomy. Both ischemic area (IA) and control region-perfused area (PA) – were scanned and video sequences were recorded.
Results: Confocal evaluation of the ischemic area revealed a different aspect of the mucosal tissue when compared to the normal perfused area. Statistically, FCD-A at the perfused area was significantly higher when compared to the ischemic area, irrespective of the time point. After 1 hour, FCD-A was (0.189 ± 0.094 vs. 0.365 ± 0.030; p=0.0001), after 2 hours (0.252 ± 0.056 vs. 0.389 ± 0.024; p<0.0001), after 3 hours (0.252 ± 0.050 vs. 0.353 ± 0.030; p=0.0001) and after 4 hours (0.262 ± 0.044 vs. 0.358 ± 0.019; p<0.0001), at ischemic and perfused areas respectively.
Conclusions: Confocal imaging allows real-time discrimination between perfused and ischemic areas of the bowel using morphological clues, while the functional capillary density area adds a quantitative measurement.