Quantitative Analysis of Intraoperative Indocyanine Green Video Angiography in Aneurysm Surgery

Abstract

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.

Intravenous indocyanine green dye is insufficient for robust immune cell labelling in the human retina

“…In clinical hepatic function studies, approximately ten-fold higher systemic ICG doses than used here have been given successfully without clear evidence of toxicity [27]. This dose has typically only been given as a bolus and given the endosomal accumulation and preferential staining of myeloid cells with phagocytic potential, it is likely more sustained exposure of cells to a minimal concentration of ICG would be needed for efficient labelling.…”

Intravenous indocyanine green dye is insufficient for robust immune cell labelling in the human retina

“…In clinical hepatic function studies, approximately ten-fold higher systemic ICG doses than used here have been given successfully without clear evidence of toxicity (25). This dose has typically only been given as a bolus and given the endosomal accumulation and preferential staining of myeloid cells with phagocytic potential, it is likely more sustained exposure of cells to a minimal concentration of ICG would be needed for efficient labelling.…”

Indocyanine Green Fluorescence to Evaluate Nasoseptal Flap Viability in Endoscopic Endonasal Cranial Base Surgery

“…Since 1972, ICG has been used routinely in a variety of cerebrovascular procedures for real-time noninvasive intraoperative angiography; thus, it has long safety history. [11][12][13][14][15] It is administered as an intravenous bolus, typically in a dose of 25 mg (dissolved in 10 mL of sterile water), binds to large plasma proteins within 2 seconds, remains intravascular, is metabolized exclusively by the liver with a plasma half-life of 150 seconds, and is excreted in bile. 17 Angiography is typically most useful after about 45 seconds of ICG administration in distinct arterial, capillary, and venous phases.…”

“…Indocyanine green (ICG) fluorescence has long been utilized for real-time angiography in vascular neurosurgery. [11][12][13][14][15] With the advent of the ICG-responsive endoscope, surgeons began exploring its use in endonasal skull base surgery. 16,17 However, its utility in delineating the arterial supply of the nasal mucosa has not yet been investigated.…”