The utility and limitations of intraoperative near-infrared indocyanine green videoangiography in aneurysm surgery

Mayur Sharma, Sudheer Ambekar, Osama Ahmed, Menarvia Nixon, Abhay Sharma, Anil Nanda, Bharat Guthikonda

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations

Abstract

Objective

Methods This retrospective study included 112 patients with 126 aneurysms who underwent microsurgical clipping and ICG videoangiography during aneurysm surgery at a single center from January 2008 to June 2013. Age, gender, aneurysm size, location, and rupture status were included in the model for analysis.

Results In 10 patients (8%), ICG videoangiography resulted in clip repositioning during surgery. Discordance between ICG videoangiography and postoperative angiography was observed in 5 patients (4%). There was no significant difference of ICG videoangiography-postoperative angiography discordance between ruptured and unruptured aneurysms (P = 0.56). On multivariate analysis, patient age, gender, aneurysm size, and rupture status did not reach significance. Ophthalmic internal carotid artery aneurysms were more likely to have discordance compared with all other aneurysms (P = 0.04; odds ratio, 10.8; confidence interval, 1.5-75.94).

Conclusions ICG videoangiography is a very useful modality for intraoperative assessment of the adequacy of aneurysmal obliteration and patency of parent and perforating vessels. However, ICG videoangiography is not absolutely reliable as a stand-alone method during clipping of ophthalmic artery aneurysms and can be complemented with intraoperative digital subtraction angiography. ICG videoangiography can be used either as an alternative or as a complementary technique to intraoperative digital subtraction angiography during aneurysm surgery.

Original languageEnglish (US)
Pages (from-to)e607-e613
JournalWorld neurosurgery
Volume82
Issue number5
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014 Elsevier Inc.

Keywords

  • Aneurysm
  • Indocyanine green
  • Near-infrared
  • Surgery
  • Videoangiography

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