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 A Case of Cervical Dural Arteriovenous Fistula evaluated by Selective Trans-arterial Indocyanine Green Videoangiography

2018 ◽  
Vol 27 (5) ◽  
pp. 402-407
Author(s):  
Yusuke Funakoshi ◽  
Taketo Hatano ◽  
Makoto Saka ◽  
Mitsushige Ando ◽  
Hideo Chihara ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Indocyanine Green Videoangiography

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.

scholarly journals Syringomyelia Associated with Spinal Dural Arteriovenous Fistula: Clinical and Radiological Improvement after Embolization

2020 ◽  
Vol 15 (3) ◽  
pp. 140-143
Author(s):  
Rakesh Singh ◽  
Narayan Deshmukh ◽  
Rakesh Lalla ◽  
Satish Khadilkar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Digital Subtraction ◽  
Resonance Imaging ◽  
Spinal Dural Arteriovenous Fistula ◽  
Arteriovenous Fistulae ◽  
Spinal Cord Dysfunction ◽  
Spinal Cord Edema

Spinal dural arteriovenous fistulae (AVF) are rare and can result in spinal cord dysfunction. We present one such case wherein the patient presented with a venous congestive myelopathy. Magnetic resonance imaging showed a syrinx formation, spinal cord edema, and flow voids. Digital subtraction angiography confirmed the dural AVF, which was treated with embolization. The syrinx disappeared, other spinal cord changes improved, and the patient had remarkable clinical improvement. The case is presented to draw attention to the rare formation of a syrinx in a spinal dural arteriovenous fistula and its disappearance after successful embolization.

scholarly journals Indocyanine Green Videoangiography in Negative: Spinal Dural Arteriovenous Fistula

2014 ◽  
Vol 5 (4) ◽  
pp. 5-6
Author(s):  
Juan Antonio Simal Julián ◽  
Pablo Miranda Lloret ◽  
Pablo Sanromán Álvarez ◽  
Laila Pérez de San Román ◽  
Andrés Beltrán Giner ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula ◽  
Indocyanine Green Videoangiography

Intraoperative Indocyanine Green Videoangiography for Spinal Vascular Lesions: Case Report

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. onsE241-onsE245 ◽  
Author(s):  
Tomohiro Murakami ◽  
Izumi Koyanagi ◽  
Takahisa Kaneko ◽  
Satoshi Iihoshi ◽  
Kiyohiro Houkin
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Digital Subtraction Angiography ◽  
Near Infrared ◽  
Vascular Lesions ◽  
Vascular Tumors ◽  
Digital Subtraction ◽  
Indocyanine Green Videoangiography ◽  
Surgical Microscope ◽  
Spinal Arteriovenous Fistula

Abstract BACKGROUND AND IMPORTANCE: In surgery of spinal vascular lesions such as spinal arteriovenous fistula or vascular tumors, assessment of feeding arteries and draining veins is important. Intraoperative digital subtraction angiography is useful but is invasive and sometimes technically demanding. Near-infrared indocyanine green (ICG) videoangiography is less invasive and has been reported as an intraoperative diagnosis of arterial patency during clipping surgery of cerebral aneurysms or bypass surgeries. We present our experience with intraoperative ICG videoangiography in 3 cases of spinal vascular lesions. CLINICAL PRESENTATION: Two patients had spinal arteriovenous fistula (perimedullary, n = 1; dural, n = 1), and 1 patient had spinal cord hemangioblastoma at the thoracic or thoracolumbar level. The surgical microscope was an OPMI Pentero (Carl Zeiss, Oberkochen, Germany). After laminectomy and opening of the dura, ICG (5 mg) was injected intravenously. The ICG angiography clearly demonstrated feeding and draining vessels. The ICG findings greatly helped successful interruption of arteriovenous fistula and total removal of the tumor. CONCLUSION: Intraoperative ICG videoangiography for spinal vascular lesions was useful by providing information on vascular dynamics directly. However, the diagnostic area is limited to the field of the surgical microscope. Although intraoperative digital subtraction angiography is still needed in cases of complex spinal vascular lesions, ICG videoangiography will be an important diagnostic modality in the field of spinal vascular surgeries.

Use of Microscope-Integrated Near-Infrared Indocyanine Green Videoangiography in the Surgical Treatment of Spinal Dural Arteriovenous Fistulae

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 978-985 ◽  
Author(s):  
Ricardo A. Hanel ◽  
Peter Nakaji ◽  
Robert F. Spetzler
Keyword(s):  
Surgical Treatment ◽  
Indocyanine Green ◽  
Digital Subtraction Angiography ◽  
Near Infrared ◽  
Type I ◽  
Spinal Angiography ◽  
Digital Subtraction ◽  
Indocyanine Green Videoangiography ◽  
Arteriovenous Fistulae ◽  
Excitation Light

Abstract OBJECTIVE Identification and complete interruption of fistulae are essential but not always obvious during the surgical treatment of spinal dural arteriovenous fistulae (dAVFs). We examined cases in which we identified and confirmed surgical obliteration of a spinal dAVF with the aid of microscope-integrated near-infrared indocyanine green (ICG) videoangiography. METHODS ICG videoangiography was performed during 6 surgical interventions in which 6 intradural dorsal AVFs (type I) were interrupted. An operating microscope-integrated light source containing infrared excitation light illuminated the operating field and was used to visualize an intravenous bolus of ICG. The locations of fistulae, feeding arteries, and draining veins and documentation of occlusion of the fistulae were compared with findings on preoperative and postoperative digital subtraction angiography. RESULTS ICG videoangiography identified the fistulous point(s), feeding arteries, and draining veins in all 6 cases, as confirmed by immediate postoperative selective spinal angiography. In 1 case, intraoperative ICG ruled out an additional questionable fistula at a contiguous level suspected on the preoperative angiography. CONCLUSION Microscope-based ICG videoangiography is simple and provides real-time information about the precise location of spinal dAVFs. During spinal dAVF surgery, this technique can be useful as an independent form of angiography or as an adjunct to intra or postoperative digital subtraction angiography. Larger series are needed to determine whether use of this modality could reduce the need for immediate postoperative spinal angiography after obliteration of intradural dorsal AVFs.

scholarly journals Application of the selective indocyanine green videoangiography in microsurgical treatment of a craniocervical junction dural arteriovenous fistula

2019 ◽  
Vol 46 (Suppl_2) ◽  
pp. V5 ◽  
Author(s):  
Liyong Sun ◽  
Jian Ren ◽  
Hongqi Zhang
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Operative Technique ◽  
Dural Arteriovenous Fistula ◽  
Craniocervical Junction ◽  
Indocyanine Green Videoangiography ◽  
Unique Type ◽  
Midline Approach ◽  
Neurovascular Anatomy ◽  
Fistula Site

Craniocervical junction dural arteriovenous fistula (CCJDAVF) is a rare and unique type of intracranial DAVF with complex neurovascular anatomy, making it difficult to identify the arterialized vein during operation. The authors report the case of a 50-year-old male who presented with symptoms of venous hypertensive myelopathy. Angiography demonstrated a left CCJDAVF. The fistula was successfully disconnected via a suboccipital midline approach. The selective indocyanine green videoangiography (SICG-VA) technique was applied to distinguish the fistula site and arterialized vein from adjacent normal vessels. Favorable clinical and angiographic outcomes were attained. The detailed operative technique, surgical nuances, and utility of SICG-VA are illustrated in this video atlas.The video can be found here: https://youtu.be/GJYl_jOJQqU.

scholarly journals Microsurgery of Spinal Dural Arteriovenous Fistula Using Indocyanine Green Video Angiography: 2-Dimensional Operative Video

2018 ◽  
Vol 17 (1) ◽  
pp. 110-110
Author(s):  
Kunio Yokoyama ◽  
Yasuaki Okuda ◽  
Makoto Yamada ◽  
Hidekazu Tanaka ◽  
Yutaka Ito ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula

scholarly journals Intracranial Dural Arteriovenous Fistulae with Pial Venous Drainage: Combined Endovascular - Neurosurgical Therapy

1997 ◽  
Vol 24 (3) ◽  
pp. 210-218 ◽  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Facial Nerve Palsy ◽  
Venous Drainage ◽  
Imaging Features ◽  
Therapeutic Approaches ◽  
Complete Cure ◽  
Group A ◽  
Glue Injection ◽  
Intracranial Dural Arteriovenous Fistulae

ABSTRACT:Background:Intracranial dural arteriovenous fistula with pial venous drainage may present with hemorrhage or focal neurologic deficit and may be difficult to treat. We wish to summarize the therapeutic approaches to these potentially dangerous lesions and to demonstrate how endovascular and neurosurgical therapies may have complimentary roles in their management.Methods:The clinical and radiological records of all patients who presented to our institution with intracranial dural arteriovenous fistula over the last 5 years were reviewed. In those cases demonstrating pial venous drainage, details of presentation, imaging features, endovascular and surgical therapy and outcome were analyzed.Results:We identified 13 patients with these lesions, 7 of whom presented with intracranial hemorrhage. Six patients were treated with embolization alone. Angiographic cure was achieved in 4. There was one complication in this group, a subarachnoid hemorrhage following glue injection. Four patients were treated with embolization followed by surgical occlusion of the pial venous drainage. Angiographic cure was achieved in all 4. There was one complication in this group, a facial nerve palsy following glue injection. Three patients were treated by surgery alone, with no complications and complete cure in all.Conclusion:Endovascular therapy of intracranial dural arteriovenous fistula may be curative but is often complex and carries definite risks. Neurosurgical ligation of pial draining veins, with pre-operative embolization when safe, may be a relatively more controlled method to achieve complete cure.

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