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

Vini G. Khurana, Kevin Seow, David Duke

    Research output: Contribution to journalArticlepeer-review

    30 Citations (SciVal)

    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.

    Original languageEnglish
    Pages (from-to)163-172
    Number of pages10
    JournalBritish Journal of Neurosurgery
    Volume24
    Issue number2
    DOIs
    Publication statusPublished - Apr 2010

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