Near-infrared indocyanine green videoangiography versus microvascular Doppler sonography in aneurysm surgery

Acta neurochirurgica
Gerrit FischerJoachim M K Oertel

Abstract

The quality of surgical treatment of intracranial aneurysms is determined by complete aneurysm occlusion and restoration of flow in the parent, branching and perforating vessels. In postoperative digital subtraction angiography (DSA), unexpected aneurysm residuals and vessel occlusions are frequently detected. Here, the value of two nearly noninvasive and cost-effective techniques for intraoperative flow evaluation (near-infrared indocyanine green video angiography (ICG-VA) and microvascular Doppler sonography (mDs)) is investigated in a prospective study. Over a period of 10 months, the authors surgically clipped 50 aneurysms under intraoperative pre- and post-clipping evaluation of flow in the parent, branching and perforating vessels and the aneurysm sack by the two techniques. Intraoperative applicability of each technique was compared to each other and to postoperative digital subtraction angiography as standard evaluation technique. Forty-five aneurysms were totally occluded without vessel compromise (90%). Intraoperatively, ICG-VA was considered useful in 43 cases (86%) and mDs in 44 cases (88%), respectively. Both techniques could compensate each other's weak points to a certain degree; but two branch occlusions (4%) an...Continue Reading

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