| Operative Effectiveness Using Indocyanine Green Videoangiography Combined with Digital Subtraction Angiography in Aneurysm Surgery in the Hybrid Operating Room |
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Hyun Jae Jeon, Hong Jun Jeon |
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Department of Neurosurgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea |
| 하이브리드 수술실에서 뇌동맥류 결찰술에 대해 인도시아닌 그린과 고식적 뇌혈관 조영술을 함께 확인한 수술적 효과 |
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전현재, 전홍준 |
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한림대학교 의과대학 강동성심병원 신경외과학교실
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| Abstract |
Objective
This study aimed to evaluate the safety and completeness of using intraoperative indocyanine green videoangiography(ICGV) combined with intraoperative angiography(IOA) for aneurysm clipping in the hybrid operating room(OR).
Methods
All patients who underwent microsurgical clipping in a traditional or hybrid OR were identified from prospectively maintained neurosurgical databases. Medical charts and operative video with ICGV and IOA were reviewed to determine the adequacy of clipping. The clinical and angiographic outcomes were retrospectively analyzed within 1 week.
Results
A total of 114 cerebral aneurysms(ruptured, 53, unruptured, 61) in 109 patients(mean age, 59; M:F=44:65) were treated with ICGV only(n=60, 22 ruptured) and ICGV plus IOA(n=54, 31 ruptured). The median aneurysm size was larger in the ICGV-IOA group(8.3±3.8mm vs 6.9±1.9mm, p=0.015). A large amount of subarachnoid hemorrhage, brain swelling, limited field of view, and number of clips repositioning occurred in the ICGV-IOA group(p<0.05). Postoperative parent vessel stenosis was more frequent in the ICGV-only group(6.1% vs 0.9%, p=0.041), but perforating vessel compromise was not different between groups(3.5% vs 1.8%, p=0.479). Aneurysm remnants were more common in the ICGV-only group(7.9% vs 1.8%, p=0.041). The use of additional IOA appears to reduce clipping-related ischemic deficits (6.1% vs 1.8%, p=0.115).
Conclusion
Using a combination of ICGV and IOA in the hybrid OR can enhance the safety and completeness of microsurgical aneurysm clipping. |
| Key Words:
Aneurysm, Angiography, Digital subtraction |
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