Application of Microscope Integrated Indocyanine Green Video-Angiography During Microneurosurgical Treatment of Intracranial Aneurysms: A Review

Dashti, Reza; Laakso, Aki; Niemelä, Mika; Porras, Matti; Çelik, Özgür; Navrátil, Ondřej; Romani, Rossana; Hernesniemi, Juha

doi:10.1007/978-3-211-99373-6_17

Cited by 28 publications

(15 citation statements)

References 38 publications

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“…First, ICG is a valuable tracer for a number of physiological and diagnostic studies and is approved for a variety of human uses [1][2][3]24]. Second, ICG concentrations in the brain tissue of human subjects can be measured by modification of commercially available noninvasive NIRS technology [4].…”

Section: Discussionmentioning

confidence: 99%

“…It has recently been introduced for intra-operative angiography during neurovascular surgery [3]. Concentrations of ICG in the human brain tissue can be determined in vivo by using near infrared spectroscopy (NIRS), and such measurements have been used for the determination of cerebral blood flow (CBF) [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Indocyanine green (ICG) is a water soluble tricarbocyanine dye that is widely used for ophthalmic angiography [1] and in physiological studies such as, the measurement of cardiac output [2] or hepatic blood flow [3]. It has recently been introduced for intra-operative angiography during neurovascular surgery [3].…”

Section: Introductionmentioning

confidence: 99%

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The feasibility of real-time in vivo optical detection of blood–brain barrier disruption with indocyanine green

et al. 2011

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Osmotic disruption of the blood-brain barrier (BBB) by intraarterial mannitol injection is sometimes required for the delivery of chemotherapeutic drugs to brain tissue. Osmotic disruption is affected by a number of factors, and there is a significant variability in the degree and distribution of BBB disruption in clinical and experimental settings. Brain tissue concentrations of indocyanine green (ICG) can be measured by optical techniques. The aim of this experiment was to determine whether the disruption of the BBB significantly altered the regional pharmacokinetics of ICG. We were able to track in vivo brain tissue concentrations of ICG in 13 New Zealand white rabbits by employing a novel optical approach. Evan's blue was used to assess the distribution of BBB disruption on post mortem examination. BBB disruption by intraarterial mannitol injection was found to be highly variable, and only five of the 13 animals demonstrated the disruption at the site of optical measurements. In these animals, we observed a ninefold increase in ICG concentrations and fourfold increase in the area under the concentration-time curve, compared to those without BBB disruption at the site of measurement. This study shows the feasibility of optical monitoring of BBB disruption with intravenous (IV) ICG injections. Virtual real-time optical monitoring of the BBB disruption could help improve intraarterial delivery of chemotherapeutic drugs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The feasibility of real-time in vivo optical detection of blood–brain barrier disruption with indocyanine green

et al. 2011

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“…Adverse reactions related to its clinical use are rare, and side effects, other than iodine allergy, have not been reported 3)9). A dose of 0.2 to 0.5 mg/kg is recommended for ICG-VA, with a maximum daily dose limit of 5 mg/kg 4)18)…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Intraoperative Indocyanine Green Video Angiography in Aneurysm Surgery

Son

Kim

Park

et al. 2013

J Cerebrovasc Endovasc Neurosurg

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ObjectiveIndocyanine green (ICG) videoangiography (VA) is being used in assessment of blood flow during cerebrovascular surgery. However, data collected during ICG angiography are usually interpreted qualitatively. In this study, quantitative analysis of ICG angiogram was attempted.Materials and MethodsICG VA, performed during aneurysm surgery was analyzed retrospectively. The angiogram was captured serially in regular time interval. The stacked images were then fed into an image analysis program, ImageJ. The selected areas of interest were as follows: parent and branch vessels, and dome of aneurysm. Changes of signals of measurement points were plotted. The time to peak, washout time, and the peak intensity between areas were compared.ResultsAmong the 16 cases enrolled in this study, five cases were anterior communicating artery aneurysms, and 11 cases were middle cerebral artery bifurcation aneurysms. There was no signal intensity of aneurysm dome in our series. No difference in time to peak or maximum signal intensity was observed between vessels in each case. The average time to peak was 9.0 and washout time was 31.3 seconds. No significant difference in time profile was observed between anterior communicating artery aneurysms and middle cerebral artery bifurcation aneurysms.ConclusionFindings of this study demonstrate that quantitative analysis is possible using a personal computer and common video capture and analysis software. It can be a good adjunctive to evaluation of vascular status during aneurysm surgery. It displays time profiles of multiple points of interest over time, and is helpful in objective evaluation of changes of blood flow over time. It might be helpful in various fields of cerebrovascular surgery.

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“…3,[20][21][22] This method, while simple and effective, has some limitations. Most important, this modality is a qualitative rather than quantitative measure of flow and may therefore not detect distal vessel hypoperfusion.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Surgical Treatment of 127 Anterior Choroidal Artery Aneurysms A Cohort Study of Resultant Ischemic Complications

Bohnstedt

Kemp

et al. 2013

Neurosurgery

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Application of Microscope Integrated Indocyanine Green Video-Angiography During Microneurosurgical Treatment of Intracranial Aneurysms: A Review

Cited by 28 publications

References 38 publications

The feasibility of real-time in vivo optical detection of blood–brain barrier disruption with indocyanine green

The feasibility of real-time in vivo optical detection of blood–brain barrier disruption with indocyanine green

Quantitative Analysis of Intraoperative Indocyanine Green Video Angiography in Aneurysm Surgery

Surgical Treatment of 127 Anterior Choroidal Artery Aneurysms A Cohort Study of Resultant Ischemic Complications

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