Intuitiveness, quality and utility of intraoperative fluorescence videoangiography: Australian Neurosurgical Experience

Date

2010

Authors

Khurana, Gautam (Vini)
Seow, K
Duke, David

Journal Title

Journal ISSN

Volume Title

Publisher

Informa Healthcare

Abstract

Introduction:The authors have undertaken a study of their intraoperative experience with indocyanine green fluorescence videoangiography (ICGFV). In particular, the intuitiveness, image quality and clinical utility of this technology have been assessed. Methods:The records of forty-six consecutive craniotomies utilising ICGFV have been retrospectively reviewed: There were 27 aneurysms, 2 extracranial-intracranial (EC-IC) bypasses, 5 arteriovenous malformations (AVM), 1 dural arteriovenous fistula (DAVF), 3 cavernomas, 5 meningiomas, and 3 gliomas. ICGFV was used in 5 awake-craniotomy patients. ICGFV was performed using a Leica OH4 surgical microscope with integrated near-infrared camera and ICG-PULSION. Results:All attempts of intraoperative ICGFV were intuitive. Image quality and resolution were excellent. Arterial and venous phases were comparable to digital subtraction angiography (DSA) but field of view was relatively limited. In 12 operations (26) the surgeon was substantially benefited from ICGFV findings. In 22 operations (48), ICGFV was useful but did not influence surgical management. ICGFV was of no benefit in 11 operations (24) and was misleading in 1 (2). In this series, ICGFV was of benefit to 1 of 11 (9) patients with an intracranial neoplasm or cavernoma. Conclusions:ICGFV is safe, intuitive and provides neurosurgeons with high quality, valuable, real-time imaging of cerebrovascular anatomy. It can assist in intraoperative surgical management and/or stroke prevention particularly during aneurysm clipping, EC-IC bypass and AVM/DAVF surgery.

Description

Keywords

Keywords: indocyanine green; adolescent; adult; aged; article; astrocytoma; Australia; brain arteriovenous malformation; brain artery aneurysm; brain tumor; camera; cavernoma; clinical article; craniotomy; digital subtraction angiography; extraintracranial anastomo Arteriovenous malformation; Dural arteriovenous fistula; Extracranial- intracranial bypass; Fluorescence videoangiography; Indocyanine green; Intracranial aneurysm

Citation

Source

British Journal of Neurosurgery

Type

Journal article

Book Title

Entity type

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Restricted until

2037-12-31