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Vizify (pudexacianinium chloride, ASP5354) is a novel small-molecule near-infrared fluorescence (NIR-F) imaging agent developed by Astellas Pharma. It is an indocyanine green (ICG) derivative conjugated with β-cyclodextrin, designed for the intraoperative visualization of the ureter during minimally invasive and open abdominopelvic surgeries, including colorectal and gynecologic procedures. Administered as a single intravenous dose, the agent is rapidly excreted by the kidneys into the urine, allowing surgeons to identify and avoid accidental ureteral injury under NIR-F imaging (excitation at 780 nm, emission at 820 nm). Unlike traditional ICG, pudexacianinium chloride does not contain iodine, reducing the risk of hypersensitivity or anaphylactic reactions. It is currently in Phase 3 clinical development.
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