Impact of indocyanine green videoangiography on rate of clip adjustments following intraoperative angiography
| Autor: | Rafael J. Tamargo, Wuyang Yang, Justin M. Caplan, Martin G. Radvany, Judy Huang, Alexander L. Coon, Geoffrey P. Colby, Eric W. Sankey |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Indocyanine Green Male medicine.medical_specialty genetic structures Adolescent Databases Factual medicine.medical_treatment chemistry.chemical_compound Young Adult Aneurysm Monitoring Intraoperative medicine Humans cardiovascular diseases Coloring Agents Craniotomy Aged Retrospective Studies Aged 80 and over business.industry Intraoperative angiography Retrospective cohort study Intracranial Aneurysm Clipping (medicine) Indocyanine green videoangiography Middle Aged medicine.disease eye diseases Single surgeon Surgery Cerebral Angiography Treatment Outcome chemistry cardiovascular system Female Neurology (clinical) business Indocyanine green |
| Zdroj: | Neurosurgery. 75(4) |
| ISSN: | 1524-4040 |
| Popis: | Background Intraoperative angiography (IA) is used to evaluate the adequacy of clip reconstruction of intracranial aneurysms. Alternative imaging such as indocyanine green videoangiography (ICG-VA) has been proposed. The additional benefit of ICG-VA when IA is routinely used has not been previously determined. Objective To report our experience with the use of ICG-VA in combination with IA vs IA alone. Methods We retrospectively reviewed cases of aneurysm clipping during a 21-month period by a single surgeon in which ICG-VA was performed after clip reconstruction prior to IA, or IA alone was performed to verify optimal clipping. Records were reviewed for age, sex, race, length of stay, rupture status, Hunt and Hess grade, aneurysm size, location, and temporary clipping. Intraoperative decision making was determined for each group. Results Ninety-four patients who underwent 97 craniotomies for 128 aneurysms met inclusion criteria for this study. ICG-VA+IA was performed in 37 craniotomies; IA alone was performed for 60 craniotomies. Baseline characteristics were similar with the exception that median aneurysm size was slightly larger in the ICG-VA group (5.6 mm vs 4.3 mm, P = .04). ICG-VA produced 4 false negatives, which required clip adjustments following IA (10.8%), vs 7 patients (11.7%) in the IA-alone group requiring clip adjustments (P = .897). Conclusion When IA is routinely performed, the additional use of ICG-VA does not eliminate the need for post-IA clip adjustments owing to the possibility of false negatives. When ICG-VA suggests optimal clipping, but is followed by IA, the rate of post-IA modifications in this study did not differ significantly than if ICG-VA had not been performed. |
| Databáze: | OpenAIRE |
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