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ICG Videoangiography in Neurosurgical Procedures

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ICG Fluorescence Imaging and Navigation Surgery

Abstract

Indocyanine green videoangiography (ICG-VAG) has recently been used for neurosurgical procedures, and its usefulness and drawbacks were evaluated. ICG-VAG showed blood flow in the vessels as the hemodynamic change of ICG fluorescence intensity. In clipping cerebral aneurysms, preservation of blood flow in the parent and perforating arteries and occlusion of the aneurysm were recognized. In bypass surgery, the patency of blood flow from the graft was observed. In carotid endarterectomy, the precise stenosis area or residual stenosis was observed before or after surgery. In removal of arteriovenous malformation, the feeding arteries, draining veins, and the nidus were clearly demonstrated. In tumor surgery, tumor-related vessels, normal brain parenchyma vessels, bridging veins, and tumor margin infiltration were observed. These findings obtained using ICG-VAG were useful to achieve these surgeries safely and completely without complications associated with the use of ICG-VAG.

Recently, the semiquantitative flow measurement using the analysis software such as FLOW 800 was used for bypass, vascular malformation, and acute stroke surgery. Endoscopic ICG-VAG was applied in aneurysm clipping and pituitary adenoma surgery.

Although there are some drawbacks associated with the use of ICG-VAG such as the presence of blind spots and the difficulty with true quantitative blood flow analysis, it is a useful intraoperative examination because of its safety and convenience.

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Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Regeneration of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Yoshiaki Kumon M.D., Ph.D.

  2. Department of Neurosurgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Hideaki Watanabe M.D., Ph.D., Shiro Ohue M.D., Ph.D. & Takanori Ohnishi M.D., Ph.D.

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  1. Yoshiaki Kumon M.D., Ph.D.
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  2. Hideaki Watanabe M.D., Ph.D.
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  3. Shiro Ohue M.D., Ph.D.
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  4. Takanori Ohnishi M.D., Ph.D.
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Correspondence to Yoshiaki Kumon M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Surgery, Seiwa Memorial Hospital, Sapporo, Hokkaido, Japan

    Mitsuo Kusano

  2. Hepato-Biliary-Pancreatic Surgery Divisi, University of Tokyo, TOKYO 113-8655, Tokyo, Japan

    Norihiro Kokudo

  3. Department of Breast Surgery Graduate Sc, Kyoto University, Kyoto, Kyoto, Japan

    Masakazu Toi

  4. Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan

    Masaki Kaibori

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Kumon, Y., Watanabe, H., Ohue, S., Ohnishi, T. (2016). ICG Videoangiography in Neurosurgical Procedures. In: Kusano, M., Kokudo, N., Toi, M., Kaibori, M. (eds) ICG Fluorescence Imaging and Navigation Surgery. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55528-5_4

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  • DOI: https://doi.org/10.1007/978-4-431-55528-5_4

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  • Online ISBN: 978-4-431-55528-5

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