Indocyanine green fluorescence video angiography reduces vascular injury-related morbidity during micro-neurosurgical clipping of ruptured cerebral aneurysms: a retrospective observational study.
Wolters Kluwer Health
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Tajsic, T., Cullen, J., Guilfoyle, M., Helmy, A., Kirollos, R., Kirkpatrick, P., & Trivedi, R. (2019). Indocyanine green fluorescence video angiography reduces vascular injury-related morbidity during micro-neurosurgical clipping of ruptured cerebral aneurysms: a retrospective observational study.. Acta neurochirurgica, 161 (11), 2397-2401. https://doi.org/10.1007/s00701-019-04029-6
Background Specific procedural complications in aneurysm surgery are broadly related to vascular territory compromise and brain/nerve retraction; vascular complications account for about half of this. Intraoperative indocyanine green video angiography (ICG-VA) provides real-time high spatial resolution imaging of the cerebrovascular architecture, allowing immediate quality assurance of aneurysm occlusion and vessel integrity. The aim of this study was to examine whether the routine use of ICG-VA reduced early procedural complications related to vascular compromise or injury during micro-neurosurgical clipping of ruptured cerebral aneurysms. Methods Retrospective comparative observational study of 412 consecutive adult good-grade (WFNS 1 or 2) SAH patients who had undergone microsurgical clipping without (n = 200, 2001–2004) or with (n = 212, 2009–2015) ICG-VA in a high-volume neurosurgical centre. Results The ICG-VA group had a significantly lower incidence of procedural vascular complications (7/212; 3.3%) compared with the non-ICG-VA group (19/200; 9.5%) (Fisher’s exact test p = 0.0137). Conclusions ICG-VA is a straightforward, easy-to-use, intraoperative adjunct which significantly reduces avoidable ‘technical error’ related morbidity.
Humans, Intracranial Aneurysm, Aneurysm, Ruptured, Intraoperative Complications, Indocyanine Green, Fluorescent Dyes, Cerebral Angiography, Monitoring, Intraoperative, Vascular Surgical Procedures, Microsurgery, Adult, Aged, Middle Aged, Female, Male
Royal College of Surgeons of England (2016/2017)
External DOI: https://doi.org/10.1007/s00701-019-04029-6
This record's URL: https://www.repository.cam.ac.uk/handle/1810/296655
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/