Format

Send to

Choose Destination
Eur Spine J. 2013 May;22 Suppl 3:S471-7. doi: 10.1007/s00586-012-2646-8. Epub 2013 Jan 12.

Indocyanine green videoangiography "in negative": definition and usefulness in spinal dural arteriovenous fistulae.

Author information

1
Neurosurgical Department, HUyP La Fe de Valencia, Blv Sur, S/N., Valencia, Spain. juanantonio.simal@gmail.com

Abstract

PURPOSE:

Indocyanine green videoangiography (IGV) has proven its effectiveness in the field of exovascular neurosurgery, both in the intracranial and spinal compartment, but is necessary to define a systematic process for the performance of the IGV to facilitate its interpretation during the procedure. We have defined and applied the concept of videoangiography "in negative" (INIGV) to spinal dural arteriovenous fistulae (dAVF) for the detection and treatment of arteriovenous shunts, so called because the first phase is performed with the vessel suggestive of being pathological occluded.

METHODS:

A Pentero-operating microscope with near-infrared IGV-integrated system (Carl Zeiss Co., Germany) was used. At our institution, 24 patients were treated for a spinal dAVF between 1995 and 2011, only in the last 4 cases, INIGV was performed.

RESULTS:

We describe the IGV in negative procedure and show the most illustrative cases. In all cases, the fistula occlusion was confirmed by postoperative selective digital subtraction angiography (DSA). INIGV demonstrate its capacity in detecting vessels not actually arterialized that should be respected and avoid some of the main limitations of the conventional IGV. This is a technical description about an Indocyanine green (ICG) videoangiographic procedure modification that is superior to merely performing ICG before and after clipping of a dAVF.

CONCLUSION:

The INIGV results are rapid and easy to interpret procedure and provide great advantages to the dAVF treatment. Nevertheless, further studies are needed with a larger sample size to determine if INIGV may reduce the need to perform immediate postoperative DSA.

PMID:
23314841
PMCID:
PMC3641275
DOI:
10.1007/s00586-012-2646-8
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center