The Impact of Microscope-Integrated Intraoperative Near-Infrared Indocyanine Green Videoangiography on Surgery of Arteriovenous Malformations and Dural Arteriovenous Fistulae

Neurosurgery ◽  
2010 ◽  
Vol 67 (4) ◽  
pp. 1094-1104 ◽  
Author(s):  
Daniel Hänggi ◽  
Nima Etminan ◽  
Hans-Jakob Steiger
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Malformations ◽  
Near Infrared ◽  
Early Passage ◽  
Indocyanine Green Videoangiography ◽  
Additional Tool ◽  
Additional Information ◽  
Arteriovenous Fistulas ◽  
Venous Phase ◽  
The Impact

Abstract BACKGROUND: Microscope-based intraoperative near-infrared indocyanine green (ICG) videoangiography is useful as an adjunct to intra- or postoperative digital subtraction angiography (DSA) in aneurysm surgery. OBJECTIVE: To evaluate intraoperative ICG videoangiography for surgery of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs). METHODS: Seventeen patients undergoing surgical resection of intracranial AVM or AVF were enrolled into this prospective evaluation. ICG videoangiography sequences were analyzed with regard to transit times to differentiate between arterial, early venous, capillary, and venous phase as well as early passage (fistula) and delayed appearance (ischemia). ICG videoangiography was compared with pre- and postoperative angiography. RESULTS: Forty-six ICG videoangiographies were performed in 17 operative procedures. In 41 ICG investigations image quality and spatial resolution were excellent to analyze arterial, early venous, capillary, and venous phase. In 2 cases ICG videoangiography provided additional information to change the surgical strategy. With the exception of one case only, the postoperative angiogram corresponded to the last ICG examination performed after the resection. No side effects related to ICG injection were observed. In one patient with a deep thalamic AVM the final ICG investigation was inconclusive owing to insufficient illumination of the deep surgical field. CONCLUSION: Microscope-integrated repetitive ICG videoangiography during AVM and dAVF surgery is fast, easy to perform, and safe. This simple and safe real-time method is a useful additional tool that can potentially lower the surgical risk in complex AVMs and help avoid missed residuals.

scholarly journals The role of microscope-integrated near-infrared indocyanine green videoangiography in the surgical treatment of intracranial dural arteriovenous fistulas

2015 ◽  
Vol 122 (4) ◽  
pp. 876-882 ◽  
Author(s):  
Harjot Thind ◽  
Douglas A. Hardesty ◽  
Joseph M. Zabramski ◽  
Robert F. Spetzler ◽  
Peter Nakaji
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
False Negative ◽  
False Negative Rate ◽  
Indocyanine Green Videoangiography ◽  
Surgical Ligation ◽  
Arteriovenous Fistulas ◽  
Negative Rate ◽  
Independent Form ◽  
Complete Obliteration

OBJECT The successful treatment of an intracranial dural arteriovenous fistula (dAVF) requires complete obliteration of blood flow through the fistulous point. Surgical ligation is often used along with endovascular techniques. Digital subtraction angiography (DSA) can be used to confirm fistula obliteration; however, this technique can be cumbersome intraoperatively and difficult to correlate anatomically with the surgical field. Near-infrared indocyanine green (ICG) videoangiography has been described as a complementary tool for this purpose. METHODS The authors examined intracranial dAVF cases in which microscope-integrated intraoperative ICG videoangiography was used to identify and/or confirm obliteration of the dAVF during surgery. Retrospective evaluation of all intracranial dAVF cases treated with surgical ligation over a 10-year period at the Barrow Neurological Institute (n = 47) revealed 28 cases in which ICG videoangiography was used. The results were compared with findings on preoperative and intraoperative or postoperative DSA. RESULTS ICG videoangiography successfully confirmed the fistulous point intraoperatively in 96% (22/23) of the cases. It also revealed complete obliteration of fistulas, comparable to intraoperative or postoperative DSA, in 91% (21/23) of the cases. The false-negative rate of ICG was 8.7% (2/23), which is similar to the false-negative rate of intraoperative DSA alone (10.5% [2/19]). CONCLUSIONS Microscope-based ICG videoangiography provides real-time information about the intraoperative anatomy of dAVFs. In addition, it can confirm complete obliteration of a fistula. This technique may be useful during dAVF surgery as an independent form of angiography or as an adjunct to intraoperative or postoperative DSA.

Evaluation of Serial Intraoperative Surgical Microscope-Integrated Intraoperative Near-Infrared Indocyanine Green Videoangiography in Patients With Cerebral Arteriovenous Malformations

2011 ◽  
Vol 70 (suppl_1) ◽  
pp. ons34-ons43 ◽  
Author(s):  
Yasushi Takagi ◽  
Keiko Sawamura ◽  
Nobuo Hashimoto ◽  
Susumu Miyamoto
Keyword(s):  
Indocyanine Green ◽  
Digital Subtraction Angiography ◽  
Arteriovenous Malformations ◽  
Near Infrared ◽  
Fluorescence Angiography ◽  
Digital Subtraction ◽  
Cerebral Arteriovenous Malformations ◽  
Viable Option ◽  
Indocyanine Green Videoangiography ◽  
Surgical Microscope

Abstract BACKGROUND: With the use of indocyanine green (ICG) as a novel fluorescent dye, fluorescence angiography has recently reemerged as a viable option. OBJECTIVE: To show the result of ICG videoangiography in cases of cerebral arteriovenous malformations. METHODS: Twenty-seven ICG videoangiography procedures were performed in 11 patients with cerebral arteriovenous malformations. Intraoperative digital subtraction angiography (DSA) was performed 27 times in these patients. The timing of intraoperative DSA was before dissection, after clipping of feeders, and after dissection of the nidus. RESULTS: The procedures were performed in 4.7 ± 1.4 minutes (mean ± SD; n = 27 minutes), whereas intraoperative digital subtraction angiography was performed for a mean of 16.6 ± 3.8 minutes (n = 27 minutes). In predissection studies, feeders were visualized by ICG in 3 of 9 cases. The nidus was visualized in all 9 cases, and drainers were visualized in 8. Intraoperative DSA visualized the feeders, nidus, and drainers in all 9 cases. After clipping of feeders, ICG videoangiography showed flow reduction of the nidus in 7 of 7 cases. Intraoperative DSA also showed that finding in 9 of 9 cases. After total dissection of the nidus, all cases disclosed that the drainers were without ICG filling. Intraoperative DSA also showed that result in all of the cases. Unexpected residual nidus was not visualized in our series with either method. CONCLUSION: We found that ICG videoangiography is helpful for resecting cerebral arteriovenous malformation. It is especially effective in visualizing the nidus and superficial drainers, as well as changes in flow after clipping or coagulating of feeders.

Indocyanine Green Videoangiography “In Negative”: Definition and Usefulness in Intracranial Dural Arteriovenous Fistulae

2013 ◽  
Vol 73 (suppl_1) ◽  
pp. ons86-ons92 ◽  
Author(s):  
Juan Antonio Julián ◽  
Pablo Miranda Lloret ◽  
Fernando Aparici Robles ◽  
Andrés Beltrán Giner ◽  
Carlos Botella Asunción
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Arteriovenous Malformations ◽  
Dural Arteriovenous Fistula ◽  
Simple Procedure ◽  
Vascular Pathology ◽  
Digital Subtraction ◽  
Indocyanine Green Videoangiography ◽  
Arteriovenous Fistulae ◽  
Intracranial Dural Arteriovenous Fistulae

Abstract BACKGROUND: Indocyanine green videoangiography (IGV) raises important limitations when we use it in vascular pathology, especially in cases with arterialization of the venous system such as arteriovenous malformations and fistulae. OBJECTIVE: Our objective was to provide a simple procedure that overcomes the limitations of conventional IGV. We define IGV in negative (IGV-IN), so-called because, in its first phase, the vessel to analyze is clipped, and we report 3 cases of intracranial dural arteriovenous fistulae treated with this procedure. METHODS: In 2011, we applied IGV-IN to 3 patients at our center with Borden type III intracranial arteriovenous fistulae. RESULTS: In all 3 cases, IGV-IN enabled both diagnosis and post-dural arteriovenous fistula exclusion control in 1 integrated procedure no longer than 1 minute, requiring only 1 visualization. CONCLUSION: IGV-IN is an improvement over the conventional IGV method and is able to provide more information in a shorter period of time. It is an intuitive and highly visual procedure, and, more importantly, it is reversible. Studies with larger samples are necessary to determine whether IGV-IN can further reduce the need for postoperative digital subtraction angiography.

scholarly journals Quantitative Analysis of Near-Infrared Indocyanine Green Videoangiography for Predicting Functional Outcomes After Spinal Intramedullary Ependymoma Resection

2019 ◽  
Vol 17 (5) ◽  
pp. 531-539 ◽  
Author(s):  
Hironori Arima ◽  
Kentaro Naito ◽  
Toru Yamagata ◽  
Shinichi Kawahara ◽  
Kenji Ohata ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Quantitative Analysis ◽  
Indocyanine Green ◽  
Functional Outcomes ◽  
Near Infrared ◽  
Peak Time ◽  
Functional Grade ◽  
Indocyanine Green Videoangiography ◽  
Peak Intensity ◽  
Ventral Spinal Cord

Abstract BACKGROUND One of the most critical steps in surgery for spinal intramedullary ependymomas is the resection of small feeding arteries from the anterior spinal artery with anatomical preservation of the normal circulation of the ventral spinal cord. OBJECTIVE To quantitatively analyze the microcirculation of the ventral spinal cord by near-infrared indocyanine green videoangiography (ICG-VA) after the spinal intramedullary ependymoma resection. METHODS This retrospective study included 12 patients (7 male and 5 female; average age 55.2 years, range 36-79 years). Patients’ neurological conditions were assessed based on the modified McCormick functional schema of grade 1 (neurologically normal) to 5 (severe deficit). Postoperative functional assessment was conducted at least 3 months after surgery. Quantitative analysis of vascular flow dynamics was carried out following spinal intramedullary ependymoma resection. Fluorescence intensities were measured and the indocyanine green (ICG) intensity-time curves were analyzed and compared with the functional outcomes after surgery. RESULTS Microscopically total or subtotal resection of the intramedullary ependymoma was achieved in all cases. Average peak time on ICG-VA was significantly shorter in the postoperative functional grade 1 to 2 group than in the postoperative functional grade 3 to 5 group, but there was no significant difference in average peak intensity between the 2 groups. Postoperative functional grade and the peak time of ICG, but not peak intensity, appeared correlated. CONCLUSION To the best of our knowledge, this is the first report showing that quantitative analysis of ICG-VA may predict functional outcomes after spinal intramedullary ependymoma resection.

scholarly journals Spectral and Hyperspectral Technologies as an Additional Tool to Increase Information on Quality and Origin of Horticultural Crops

Agronomy ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 7
Author(s):  
Maria Luisa Amodio ◽  
Muhammad Mudassir Arif Chaudhry ◽  
Giancarlo Colelli
Keyword(s):  
Biological Tissue ◽  
Near Infrared ◽  
Cultural Practices ◽  
Consumer Preferences ◽  
Storage Conditions ◽  
Minimal Processing ◽  
Additional Tool ◽  
Horticultural Crops ◽  
Table Grapes ◽  
The Impact

Nowadays, consumer awareness of the impact of site of origin and method of production on the quality and safety of foods, and particularly of fresh produce, is driving the research towards developing various techniques to assist present certifications, traceability, and audit procedures. With regard to horticultural produce, consumer preferences have shifted to fruit and vegetables, which are healthy and ecologically produced, and toward processed foods having sustainable or social certifications and with sites of origin clearly reported on the label. Some recent studies demonstrate the potentiality of near infrared (NIR) technology (including hyperspectral imaging) for discriminating fresh and processed horticultural products based on their composition, quality attributes, and origin. These studies principally mention that each biological tissue possesses a fingerprint NIR spectrum, which consists of a unique and characteristic pattern of radiation, distinguishing a particular biological tissue from physically and/or chemically different samples. Particularly, recent studies discriminated apples, wine, wheat kernels, and derived flours based on their geographical origins. Spectral information allowed discrimination among growing methods (organic and conventional) for asparagus and strawberry fruits, and among harvest dates for fennels, table grapes, and artichokes. Moreover, information about freshness and storage days after minimal processing can be obtained. Recent literature and original results will be discussed. From our perspective, present results suggest that these techniques may have a potentiality to increase information about product history, but if and only if the variability captured by the classification models is vast in terms of diverse samples belonging to various cultivars, varieties, harvest times, cultural practices, geographical origins, storage conditions, and maturity stages, while being used as a complementary method to the conventional ones―either to make an initial screening of critical features, or to add to the amount of available information. Lacking the inclusion of these parameters could result in good classification results, but the reliability of the classification in this case would be dubious in terms of assessment of the factor contributing towards correct classification.

Arteriovenous malformations and intraoperative indocyanine green videoangiography: Preliminary experience

2011 ◽  
Vol 59 (1) ◽  
pp. 97 ◽  
Author(s):  
Graziano Taddei ◽  
ClaudioDe Tommasi ◽  
Alessandro Ricci ◽  
RenatoJ Galzio
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Malformations ◽  
Indocyanine Green Videoangiography
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