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Cerebral vascular malformation is an abnormal blood vessel formation in the brain.
Brain arteriovenous malformation (bAVM) surgeries are one of the most difficult to perform because they required considerable surgical skills and identification of feeding vessels to prevent passage vessel injuries and preserve draining veins until the final stage of the procedure.
Indocyanine green (ICG) angiography is an essential intraoperative adjunct to distinguish between arteries and veins or between normal and abnormal vascular components in bAVM surgeries. However, its application has several pitfalls that should be considered. Dual-image videoangiography, a high-resolution intraoperative imaging system used to simultaneously visualize both visible light and near-infrared fluorescence images of ICG angiography, would be useful in bAVM surgeries.
KeywordsBrain arteriovenous malformation Feeding vessel Indocyanine green angiography Dual-image videoangiography Draining vein
This is a case of left parietal arteriovenous malformation ( AVM) . After opening the dura mater, we gave a low dose of indocyanine green ( ICG) intravenously. We could reduce the administered ICG dose due to the good fluorescence sensitivity of the laser light. We could perform a safe surgical procedure observing the blood flow under direct vision. After giving repeated doses of ICG and confirming the AVM occlusion, we removed the AVM. (MOV 2367778 kb)
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