Indocyanine green videoangiography for the identification of superficial temporal artery branches in EC-IC bypass surgery

Acta neurochirurgica
Giuseppe EspositoLuca Regli

Abstract

Superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass remains an essential tool for managing complex cerebrovascular conditions. A crucial surgical step is the identification and safe dissection of the bypass donor artery. If the frontal branch of the STA is used, a curvilinear fronto-temporal scalp flap generally allows for a clean dissection from the underside of the scalp flap. This dissection is sometimes tedious, since the frontal branch is not always easily visible and due to variability of its anatomy. With this article, we report on the feasibility and effectiveness of a simple indocyanine green videoangiography (ICG-VA)-assisted technique for the identification of the STA branches from the underside of a fronto-temporal scalp flap in bypass surgery. The technique is based on the analysis of the difference in timing of filling of scalp vessels illuminated via ICG-VA from the underside of a scalp flap. Three illustrative cases are reported. ICG-VA permitted the correct identification and safe dissection of the donor vessels (STA branches) in all three patients. There were no complications due to the ICG-VA. This technique allows reliable visualization of the STA and its branches at once before microsurgi...Continue Reading

References

May 26, 2004·Neurosurgery·David W Newell, Marcelo D Vilela
Jan 22, 2005·Journal of Neurosurgery·Masatou KawashimaKiyotaka Fujii
Mar 29, 2006·Surgical and Radiologic Anatomy : SRA·Yelda Atamaz Pinar, Figen Govsa
Aug 22, 2008·Neurosurgery·Laligam N SekharBasavaraj Ghodke
Jul 18, 2014·Clinical Neurology and Neurosurgery·A ScerratiG Esposito

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Citations

Jan 13, 2018·Acta neurochirurgica·Giuseppe Esposito, Luca Regli

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