| Usefulness of the Intraoperative Fluorescein Videoangiography During Cerebral Aneurysm Surgery |
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Jong Duck Yoo, Suk Jung Jang |
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Department of Neurosurgery, Chosun University College of Medicine, Gwangju, Korea |
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| Abstract |
Objective
Videoangiography is a important technology to confirm complete aneurysm obliteration and the patency of parental, branching, or perforating arteries. Many authors have reported advantages and disadvantages of indocyanine green-videoangiography(ICG-VA), but the number of studies of fluorescein-videoangiography(F-VA) remains limited. The aim of this study compares F-VA with ICG-VA and defines the advantages of F-VA.
Methods
The study population included 117 patients who underwent surgical aneurysm clipping between May 2016 and September 2017. Medical records, radiologic results, and intraoperative video recordings were reviewed retrospectively.
Results
The operator readjusted the clip using ICG-VA alone in 13 of 118 cases(11%). In 13 cases, 6 cases(5%) had residual aneurysms and 7 cases(6%) had vessels occlusions. In 31 cases(26%), Intraoperative fields were not clearly seen after ICG-VA alone. In 44 cases(37.3%), operation was required assessment by F-VA after using ICG-VA. Use of F-VA was higher in ruptured aneurysms(38.9%) than unruptured aneurysms(32.1%), Hunt-Hess grade III, IV (45.5%) than I, II(32.6%), and Fisher grade III, IV(40.6%) than I, II(33.3%). F-VA was frequently used in the as anterior communicating artery, anterior choroidal artery, vertebral artery-posterior inferior cerebellar artery, and basilar artery.
Conclusion
If ICG-VA results are uncertain, F-VA should be considered as an additional technique, especially in cases of ruptured aneurysm, Fisher grade III, IV, Hunt-Hess grade III, IV, and deep-seated aneurysm. |
| Key Words:
Aneurysm, Fluorescein, Indocyanine green, Videoangiography |
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