Procedural Paradigm in Intraoperative Aneurysm Clipping with Microdoppler Ultrasound, Near-Infrared Indocyanine Green Videoangiography and Intraoperative Angiography

Abstract

Introduction: The aim of surgical treatment of aneurysm is complete aneurysm obliteration and maintenance of a physiologic flow in the proximal and distal vessels. To avoid any risks of failing these aims intraoperativeangiography was introduced in neurosurgery first, followed by microdoppler-ultrasonography and lately with Indocyanine-Green-Videoangiography (ICG-VA). After reviewing the literature and analysing our own results with the different methods we propose an intraoperative paradigm to optimize aneurysm clipping with the least risk of vessel occlusion or residual aneurysm.