Indocyanine green video-angiography in neurosurgery: A glance beyond vascular applications

Abstract

OBJECTIVE: Indocyanine green video angiography (ICG-VA) is a non invasive, easy to use and a very useful tool for various neurosurgical procedures. Initially introduced in vascular neurosurgery since 2003, it's applications have broadened over time, both in vascular applications and in other neurosurgical fields. The objective of our study is to review all published literature about ICG-VA, cataloguing its different applications. METHODS: A systematic review of all pertinent literature articles published from January 2003 to May 2014 using Pubmed access was performed using pertinent keywords; cross check of references of selected articles was performed in order to complete bibliographical research. Results of research were grouped by pathology. RESULTS AND CONCLUSIONS: The paper systematically analyses ICG-VA different applications in neurosurgery, from vascular neurosurgery to tumor resection and endoscopic applications, focusing on reported advantages and disadvantages, and discussing future perspectives. Disclosure statement: the authors declare no interest to disclose, they have any personal or institutional financial interest in drugs, materials, or devices described in this submission and that they did not receive any specific funding. The paper and any of its contents have been presented DOI Methods:A systematic review of all pertinent literature articles published from January 2003 to May 2014 using Pubmed access was performed using pertinent keywords; cross check of references of selected articles was performed in order to complete bibliographical research. Results of research were grouped by pathology. Results and ConclusionsThe paper systematically analyses ICG-VA different applications in neurosurgery, from vascular neurosurgery to tumour resection and endoscopic applications, focusing on reported advantages and disadvantages, and discussing future perspectives.

Application of indocyanine green video angiography in surgical treatment of intracranial aneurysms

“…ICG is a valuable tool to assess intraoperative details in vascular neurosurgical procedures 1,2,3,4,5,6 . There are several clinical applications (Table 2) and main advantages of ICG are the high contrast view, allowing only the target, not background, to be visible ( Figure 2); the dye is confined to the vascular compartment through binding with plasma proteins; low toxicity and the rapid excretion, almost exclusively into the bile.…”

“…Additionally, Brazilian literature has no publication about such theme to the best of our knowledge. We report below the first Brazilian experience with application of ICG in the treatment of intracranial aneurysms 4,5,6 . …”

“…Additionally, Brazilian literature has no publication about such theme to the best of our knowledge. We report below the first Brazilian experience with application of ICG in the treatment of intracranial aneurysms 4,5,6 . 1 Iamspe, Hospital do Servidor Público Estadual de São Paulo, Departamento de Neurocirurgia, Sao Paulo SP, Brazil; metHoD This study describes the surgical results of a senior vascular neurosurgeon (Pahl FH).…”

“…However, it was used for angiography in the 60´s and for retinal angiography in the 70´s. The principle of fluorescence imaging used in ICG is simple: illuminate the tissue of interest with light at the excitation wavelength (800 nm) while observing it at longer emission wavelengths (over 800 nm) 1,2,3,4,5 .Neurosurgery is ideal for ICG because operations are already done using microscope (and camera), and because the blood vessels located on the brain surface are exposed and thus can be seen more or less directly by visual means. Thus, ICG applied in vascular neurosurgical procedures has emerged as a valuable option to assess intraoperatively details of aneurysmal clipping 4,5,6,.…”

“…However, it was used for angiography in the 60´s and for retinal angiography in the 70´s. The principle of fluorescence imaging used in ICG is simple: illuminate the tissue of interest with light at the excitation wavelength (800 nm) while observing it at longer emission wavelengths (over 800 nm) 1,2,3,4,5 .…”