Artikel
Prospective evaluation of surgical microscope-based indocyanine green video angiography in aneurysm surgery
Prospektive Evaluierung der mikroskopgestützten Indozyaningrün-Videoangiographie in der Aneurysmachirurgie
Suche in Medline nach
Autoren
Veröffentlicht: | 23. April 2004 |
---|
Gliederung
Text
Objective
We report about an ongoing prospective trial comparing a new technique of indocyanine green video angiography (ICGA) with intraoperative or postoperative DSA.
Methods
ICGA was performed during aneurysm surgery using a newly developed Zeiss microscope (Zeiss, Oberkochen, Germany). A microscope integrated light source containing infrared excitation light illuminates the operating field. After intravenous injection of the indocyanine dye (25 mg), intravascular fluorescence of ICG from within vessels is imaged by a microscope video camera. Patency of parent, branching and perforating arteries and clip occlusion of the aneurysm as found by ICGA were compared to intraoperative or postoperative DSA findings.
Results
A total of 56 ICGA procedures were performed in 36 patients. Image quality and resolution was excellent and allowed intraoperative real-time assessment of visible parent, branching and perforating arteries. In all 36 patients, intraoperative or postoperative angiography corresponded to the intraoperative findings of ICGA. Patency of perforating arteries could be assessed on all ICG angiograms and none of the conventional angiograms. In cases where relevant structures were not visible to the surgeon through the operating microscope, DSA provided more information than ICGA. ICG angiograms could generally be performed in less than two minutes. No reactions to the ICG dye were observed.
Conclusions
Microscope-based ICGA is simple and provides real-time information about the patency of blood vessels of all relevant diameters and about the aneurysm sac. ICGA may be used as an alternative to intraoperative angiography in many aneurysm cases.