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학술저널
저자정보
Dutta Gautam (Department of Neuro-Surgery Rajendra Institute of Medical Sciences (RIMS) Ranchi Jharkhand India) Jagetia Anita (Department of Neuro-Surgery Govind Ballabh Pant Institute of Postgraduate Medical Education and Res) Srivastava Arvind K (Department of Neuro-Surgery Govind Ballabh Pant Institute of Postgraduate Medical Education and Res) Singh Daljit (Department of Neuro-Surgery Govind Ballabh Pant Institute of Postgraduate Medical Education and Res) Singh Hukum (Department of Neuro-Surgery Govind Ballabh Pant Institute of Postgraduate Medical Education and Res) Chawla Rajiv (Department of Neuro-Anesthesia Govind Ballabh Pant Institute of Postgraduate Medical Education and) Agarwal Atul (Department of Neuro-Surgery Govind Ballabh Pant Institute of Postgraduate Medical Education and Res) Iqbal Mohd (Department of Neuro-Surgery Govind Ballabh Pant Institute of Postgraduate Medical Education and Res) Tandon Monica (Department of Neuro-Anesthesia Govind Ballabh Pant Institute of Postgraduate Medical Education and)
저널정보
대한뇌혈관외과학회 Journal of Cerebrovascular and Endovascular Neurosurgery Journal of Cerebrovascular and Endovascular Neurosurgery Vol.23 No.3
발행연도
2021.9
수록면
210 - 220 (11page)
DOI
10.7461/jcen.2021.E2020.10.003

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Objective Indocyanine green video angiography (ICG-VA) is a routine while performing vascular surgery to assess patency of perforators, completeness of clipping and/or to assess patency of anastomosis. Its usefulness in assessing cerebral blood flow and perfusion is not well studied. This study is aimed to assess the cerebral blood flow and perfusion after temporary clipping and to correlate with the risk of ischemia. Methods Prospective analysis of intra-operative ICG-VA performed during temporary arterial occlusion in 38 patients from January 2014 to December 2018 was conducted. Co-relation with post-operative MR diffusion weighted imaging (MR DWI) in terms of vascular territory of interest within 48 hours of surgery was performed. Clinical outcome was assessed using modified Rankin Scale (mRS) score 1-month post-surgery. Results 43 aneurysms in 38 patients clipped using ICG-VA were included in this study. No side effect of ICG dye was seen in any patients. The number of times temporary clips applied had a direct relationship to the delay in appearance of ICG in the surgical field which became statistically significant after application of 3rd temporary clip. Nine (23.7%) patients developed ischemia following the procedure confirmed by post-operative MR DWI and all the ischemic cases had visible decrease in ICG fluorescence post-temporary clipping. Conclusions No previous study had tried to assess the intraoperative cerebral blood flow and perfusion during temporary clipping of parent vessels during aneurysm surgery. The use of ICG-VA can be extended to assess perfusion in desired territory by merely assessing the degree of opacification.
#Indocyanine green #Temporary arterial occlusion #Aneurysm #Intracranial #Cerebral blood flow

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참고문헌 (22)

참고문헌 신청
Chandler JP / 1998 / Intraoperative aneurysm rupture complication avoidance / Neurosurg Clin N Am 9(4):861~868 google schola Charbel FT / 1991 / Temporary clipping in aneurysm surgery : technique and results / Surg Neurol 36(2):83~90 google schola David CA / 1996 / Cerebral protection by intermittent reperfusion during temporary focal ischemia in the rat / J Neurosurg 85(5):923~928 google schola de Oliveira JG / 2008 / Assessment of flow in perforating arteries during intracranial aneurysm surgery using intraoperative near-infrared indocyanine green videoangiography / Neurosurgery 62(6 Suppl 3):1300~1310 google schola Doss VT / 2015 / Comparison of intraoperative indocyanine green angiography and digital subtraction angiography for clipping of intracranial aneurysms / Interv Neurol 3(3-4):129~134 google schola

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