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Acta Neurochirurgica
Published in: Acta Neurochirurgica 11/2019

Open Access 01-11-2019 | Subarachnoid Hemorrhage | Original Article - Vascular Neurosurgery - Aneurysm

Indocyanine green fluorescence video angiography reduces vascular injury–related morbidity during micro-neurosurgical clipping of ruptured cerebral aneurysms: a retrospective observational study

Authors: Tamara Tajsic, James Cullen, Mathew Guilfoyle, Adel Helmy, Ramez Kirollos, Peter Kirkpatrick, Rikin Trivedi

Published in: Acta Neurochirurgica | Issue 11/2019

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Abstract

Background

Specific procedural complications in aneurysm surgery are broadly related to vascular territory compromise and brain/nerve retraction; vascular complications account for about half of this. Intraoperative indocyanine green video angiography (ICG-VA) provides real-time high spatial resolution imaging of the cerebrovascular architecture, allowing immediate quality assurance of aneurysm occlusion and vessel integrity. The aim of this study was to examine whether the routine use of ICG-VA reduced early procedural complications related to vascular compromise or injury during micro-neurosurgical clipping of ruptured cerebral aneurysms.

Methods

Retrospective comparative observational study of 412 adult good-grade (WFNS 1 or 2) SAH patients who had undergone microsurgical clipping without (n = 200, 2001–2004) or with (n = 212, 2009–2015) ICG-VA in a high-volume neurosurgical centre.

Results

The ICG-VA group had a significantly lower incidence of procedural vascular complications (7/212; 3.3%) compared with the non-ICG-VA group (19/200; 9.5%) (Fisher’s exact test p = 0.0137).

Conclusions

ICG-VA is a straightforward, easy-to-use, intraoperative adjunct which significantly reduces avoidable ‘technical error’ related morbidity.
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Metadata
Title
Indocyanine green fluorescence video angiography reduces vascular injury–related morbidity during micro-neurosurgical clipping of ruptured cerebral aneurysms: a retrospective observational study
Authors
Tamara Tajsic
James Cullen
Mathew Guilfoyle
Adel Helmy
Ramez Kirollos
Peter Kirkpatrick
Rikin Trivedi
Publication date
01-11-2019
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 11/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-019-04029-6

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