Indocyanine green video angiography in vascular neurosurgery

2020 ◽  
Vol 8 (2) ◽  
pp. 71
Author(s):  
JaspreetSingh Dil
Keyword(s):  
Indocyanine Green ◽  
Vascular Neurosurgery

Intraoperative indocyanine green angiography for obliteration of a spinal dural arteriovenous fistula

2009 ◽  
Vol 11 (6) ◽  
pp. 705-709 ◽  
Author(s):  
Geoffrey P. Colby ◽  
Alexander L. Coon ◽  
Daniel M. Sciubba ◽  
Ali Bydon ◽  
Philippe Gailloud ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Vascular Anatomy ◽  
Endovascular Embolization ◽  
Spinal Dural Arteriovenous Fistula ◽  
Lower Extremity Weakness ◽  
Spinal Arteriovenous Malformation ◽  
Arteriovenous Fistulas ◽  
Icg Angiography ◽  
Clip Occlusion ◽  
Vascular Neurosurgery

Spinal dural arteriovenous fistulas (DAVFs) are the most common type of spinal arteriovenous malformation and are an important, underdiagnosed cause of progressive myelopathy and morbidity in patients with spine disorders. Successful microsurgical management of these lesions is dependent on the surgeon's ability to identify vessels of the fistula and to confirm its successful obliteration postintervention. Indocyanine green (ICG) fluorescent angiography is an emerging tool for delineating intraoperative vascular anatomy, and it has significant potential utility in the treatment of vascular disease in the spine. The authors present the case of a 76-year-old man with progressive and debilitating bilateral lower-extremity weakness and numbness on exertion, in whom a left T-8 spinal DAVF was diagnosed based on results of conventional spinal angiography. Unfavorable anatomy based on angiographic findings precluded endovascular embolization of the fistula, and the patient subsequently underwent T7–9 bilateral laminectomies for microsurgical clip occlusion. Intraoperative ICG fluorescent angiography was used before clip placement to identify the arterialized veins of the fistula, and after clip placement to confirm obliteration of the fistulous connection and restoration of normal blood flow. Intraoperative ICG angiography serves an important role in the microsurgical treatment of DAVF. It can be used to map the anatomy of the fistula in real time during surgery and to verify fistula obliteration rapidly after clip placement. This report adds to the growing body of literature demonstrating the importance of ICG angiography in vascular neurosurgery of the spine.

Real-Time Overlapping of Indocyanine Green—Video Angiography With White Light Imaging for Vascular Neurosurgery: Technique, Implementation, and Clinical Experience

2020 ◽  
Vol 19 (4) ◽  
pp. 453-460 ◽  
Author(s):  
Dimitrios Athanasopoulos ◽  
Axel Heimann ◽  
Makoto Nakamura ◽  
Irini Kakaletri ◽  
Oliver Kempski ◽  
...  
Keyword(s):  
Blood Flow ◽  
Indocyanine Green ◽  
Real Time ◽  
White Light ◽  
Multispectral Imaging ◽  
Tissue Perfusion ◽  
Indocyanine Green Videoangiography ◽  
Black And White ◽  
Surgical Clip ◽  
Vascular Neurosurgery

Abstract BACKGROUND Fluorescent-guided techniques in vascular neurosurgery can be demonstrated via black and white indocyanine green videoangiography (ICG-VA). Multispectral imaging (MFL) is a new method, which overlaps fluorescence with the white light and provides a fluorescent white light augmented reality image to the surgeon. OBJECTIVE To investigate (a) whether MFL can enhance the visualization of the blood-flow with simultaneous visualization of the anatomic structures and (b) if MFL can ergonomically improve the microvascular surgical treatment compared to ICG-VA. METHODS A digital imaging of the blood flow after intravenous injection of ICG on 7 pigs was performed in real time under white light, standard fluorescence, and MFL. The blood flow was interrupted with a surgical clip, demonstrating the blockage of the blood flow. We prospectively included 30 patients with vascular deformities. The vasculature was visualized on the microscope's monitor and through the microscope's eyepiece. RESULTS In the animal experiment, the visualization of the anatomy and the blood flow under MFL produced high resolution images. The occlusion of blood vessels demonstrated sufficiently the blockage of tissue perfusion and its reperfusion after clip removal. During all 30 surgical cases, the MFL technique and the direct delivery of the pseudo-colored image through the eyepiece allowed for enhanced anatomic and dynamic data. CONCLUSION MFL was shown to be superior to the classic ICG-VA, delivering enhanced data and notably improving the workflow due to the simultaneous and precise white light visualization of the blood flow and the surrounding anatomic structures.

Application of indocyanine green video angiography in vascular neurosurgery

2020 ◽  
Vol 63 (6) ◽  
Author(s):  
Enrico Marchese ◽  
Giuseppe M. Della Pepa ◽  
Giuseppe La Rocca ◽  
Alessio Albanese ◽  
Tamara Ius ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Vascular Neurosurgery

PROSPECTIVE EVALUATION OF SURGICAL MICROSCOPE–INTEGRATED INTRAOPERATIVE NEAR-INFRARED INDOCYANINE GREEN ANGIOGRAPHY DURING CEREBRAL ARTERIOVENOUS MALFORMATION SURGERY

Neurosurgery ◽  
2009 ◽  
Vol 65 (3) ◽  
pp. 456-462 ◽  
Author(s):  
Brendan D. Killory ◽  
Peter Nakaji ◽  
L. Fernando Gonzales ◽  
Francisco A. Ponce ◽  
Scott D. Wait ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
Fluorescence Angiography ◽  
Digital Subtraction ◽  
Arteriovenous Shunting ◽  
Icg Angiography ◽  
Normal Vessel ◽  
Vascular Neurosurgery ◽  
Postoperative Findings ◽  
Angiographic Findings

Abstract OBJECTIVE Microscope-integrated indocyanine green (ICG) fluorescence angiography is a novel technique in vascular neurosurgery with potential utility in treating arteriovenous malformations (AVMs). METHODS We analyzed the application of intraoperative ICG in 10 consecutive AVM surgeries for which surgical video was available. The ability to distinguish AVM vessels (draining veins, feeding and nidal arteries) from each other and from normal vessel was evaluated, and ICG angiographic findings were correlated with intra- and postoperative findings on digital subtraction angiography (DSA). RESULTS ICG angiography was found to be useful by the surgeon in 9 of 10 patients. In 8 patients, it helped to distinguish AVM vessels. In 3 of 4 patients undergoing a postresection injection, it demonstrated that there was no residual arteriovenous shunting. In 1 patient, it helped to identify a small AVM nidus that was otherwise inapparent within a hematoma. Intraoperative DSA showed residual AVM in 2 of 10 patients requiring further resection of AVM not visualized during surgery. CONCLUSION Microscope-integrated ICG angiography is a useful tool in AVM surgery. It can be used to distinguish AVM vessels from normal vessels and arteries from veins based on the timing of fluorescence with the dye. Our experience suggests that it is less useful with deep-seated lesions or when AVM vessels are not on the surface. ICG angiography complements rather than replaces DSA.

scholarly journals Application of indocyanine green video angiography in surgical treatment of intracranial aneurysms

2015 ◽  
Vol 73 (7) ◽  
pp. 607-610 ◽  
Author(s):  
Felix Hendrik Pahl ◽  
Matheus Fernandes de Oliveira ◽  
Roger Schmidt Brock ◽  
José Erasmo Dal’Col Lucio
Keyword(s):  
Indocyanine Green ◽  
Intracranial Aneurysms ◽  
Imaging Technique ◽  
Surgical Results ◽  
High Quality ◽  
Quality Work ◽  
Vascular Structures ◽  
Vascular Neurosurgery ◽  
Medical Indications ◽  
Time Evaluation

Indocyanine green (ICG) video angiography has been used for several medical indications in the last decades. It allows a real time evaluation of vascular structures during the surgery. This study describes the surgical results of a senior vascular neurosurgeon. We retrospectively searched our database for all aneurysm cases treated with the aid of intraoperative ICG from 2009 to 2014. A total of 61 aneurysms in 56 patients were surgically clipped using intraoperative ICG. Clip reposition after ICG happened in 2 patients (3.2%). Generally, highly variable clip adjustment rates of 2%–38% following ICG have been reported since the introduction of this imaging technique. The application of ICG in vascular neurosurgery is still an emerging challenge. It is an adjunctive strategy which facilitates aneurismal evaluation and treatment in experienced hands. Nevertheless, a qualified vascular neurosurgeon is still the most important component of a high quality work.

Enhanced type I photoreaction of indocyanine green via electrostatic-force-driven aggregation

Nanoscale ◽  
2020 ◽  
Vol 12 (17) ◽  
pp. 9517-9523 ◽  
Author(s):  
Huizhen Fan ◽  
Yu Fan ◽  
Wenna Du ◽  
Rui Cai ◽  
Xinshuang Gao ◽  
...  
Keyword(s):  
Mesoporous Silica ◽  
Indocyanine Green ◽  
Electrostatic Force ◽  
Type I ◽  
Positively Charged

ICG forms aggregates in positively charged mesoporous silica, which show an enhanced type I photoreaction pathway.

Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease

VASA ◽  
2017 ◽  
Vol 46 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Henrik Christian Rieß ◽  
Anna Duprée ◽  
Christian-Alexander Behrendt ◽  
Tilo Kölbel ◽  
Eike Sebastian Debus ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Quantitative Assessment ◽  
Tissue Perfusion ◽  
Fluorescent Imaging ◽  
Peripheral Artery ◽  
Peripheral Bypass ◽  
Before And After ◽  
Artery Disease ◽  
Green Fluorescent ◽  
Peripheral Bypass Grafting

Abstract. Background: Perioperative evaluation in peripheral artery disease (PAD) by common vascular diagnostic tools is limited by open wounds, medial calcinosis or an altered collateral supply of the foot. Indocyanine green fluorescent imaging (ICG-FI) has recently been introduced as an alternative tool, but so far a standardized quantitative assessment of tissue perfusion in vascular surgery has not been performed for this purpose. The aim of this feasibility study was to investigate a new software for quantitative assessment of tissue perfusion in patients with PAD using indocyanine green fluorescent imaging (ICG-FI) before and after peripheral bypass grafting. Patients and methods: Indocyanine green fluorescent imaging was performed in seven patients using the SPY Elite system before and after peripheral bypass grafting for PAD (Rutherford III-VI). Visual and quantitative evaluation of tissue perfusion was assessed in an area of low perfusion (ALP) and high perfusion (AHP), each by three independent investigators. Data assessment was performed offline using a specially customized software package (Institute for Laser Technology, University Ulm, GmbH). Slope of fluorescent intensity (SFI) was measured as time-intensity curves. Values were compared to ankle-brachial index (ABI), slope of oscillation (SOO), and time to peak (TTP) obtained from photoplethysmography (PPG). Results: All measurements before and after surgery were successfully performed, showing that ABI, TTP, and SOO increased significantly compared to preoperative values, all being statistically significant (P < 0.05), except for TTP (p = 0.061). Further, SFI increased significantly in both ALP and AHP (P < 0.05) and correlated considerably with ABI, TTP, and SOO (P < 0.05). Conclusions: In addition to ABI and slope of oscillation (SOO), the ICG-FI technique allows visual assessment in combination with quantitative assessment of tissue perfusion in patients with PAD. Ratios related to different perfusion patterns and SFI seem to be useful tools to reduce factors disturbing ICG-FI measurements.

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