The first experience of intraoperative infrared videoangiography usage during cerebral aneurysms clipping
Abstract
Objective. To review the results of intraoperative indocyanine green videoangiography (ICG-VA) usage during clipping of cerebral aneurysms distinguishing the interpretation features of obtained data in accordance with time of contrast injection - before or after aneurysm clipping. Material and methods. We conducted ICG-VA at 28 patients with ruptured cerebral aneurysms among them 12 persons were operated on in acute period of hemorrhage and 16 patients - in delayed or cold period. This procedure was performed using operative microscope OPMI Pentero with plug-in Infrared-800 module, which was switched on at the certain stage of operation. There were 34 examination in total with contrast injection before aneurysm clipping in 12 cases and after clipping - 22 observations. Results. The high informative value of ICG-VA was demonstrated during revision of clipping site for patency determination of parent artery and perforating branches. The differences in angiographic signs of aneurysm elimination from blood flow depending on method of contrast injection were determined. The inversion of ICG-VA data was described in particular, indicating the aneurysm elimination in case of preliminary contrast of arteries, when applied clip may block some quantity of contrast in aneurysmal body whereas the contrast agent is washing out from parent vessels. Conclusion. ICG-VA is the optimal method for objective estimation of aneurysm clipping adequacy. The hemodynamics features in examined region before and after temporary or permanent clips placement must be taken into consideration. ICG-VA decreases the risk of possible complications in aneurysm surgery; the clip replacement was necessary in our 5 clinical observations.
About the Authors
L. Ya. Kravets
ФГБУ «Нижегородский НИИ травматологии и ортопедии» МЗ РФ
Russian Federation
Russian Federation
A. N. Nikolaev
Городская клиническая больница № 13 Автозаводского района
Russian Federation
Russian Federation
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Review
For citations:
Kravets L.Ya., Nikolaev A.N. The first experience of intraoperative infrared videoangiography usage during cerebral aneurysms clipping. Russian journal of neurosurgery. 2015;(1):41-45. (In Russ.)
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