Applications of Microscope-Integrated Indocyanine Green Videoangiography in Cerebral Revascularization Procedures

Frontiers in Surgery

article

Claudio Cavallo¹  Sirin Gandhi¹  Xiaochun Zhao¹  Evgenii Belykh¹  Daniel Valli¹  Peter Nakaji¹  Mark C. Preul¹  Michael T. Lawton¹ 

[1] Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, United States

关键词: indocyanine green videoangiography;    cerebral revascularization;    extracranial-intracranial bypass;    intracranial-intracranial bypass;    graft patency;   

DOI  :  10.3389/fsurg.2019.00059

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Indocyanine green videoangiography (ICG-VA) is a near-infrared range fluorescent marker used for intraoperative real-time assessment of flow in cerebrovascular surgery. Given its high spatial and temporal resolution, ICG-VA has been widely established as a useful technique to perform a qualitative analysis of the graft patency during revascularization procedures. In addition, this fluorescent modality can also provide valuable qualitative and quantitative information regarding the cerebral blood flow within the bypass graft and in the territories supplied. Digital subtraction angiography (DSA) is considered to be the gold standard diagnostic modality for postoperative bypass graft patency assessment. However, this technique is time and labor intensive and an expensive interventional procedure. In contrast, ICG-VA can be performed intraoperatively with no significant addition to the total operative time and, when used correctly, can accurately show acute occlusion. Such time-sensitive ischemic injury detection is critical for flow reestablishment through direct surgical management. In addition, ICG has an excellent safety profile, with few adverse events reported in the literature. This review outlines the chemical behavior, technical aspects, and clinical implications of this tool as an intraoperative adjunct in revascularization procedures.

【 授权许可】

CC BY