Marchese Enrico, Della Pepa Giuseppe M, La Rocca Giuseppe, Albanese Alessio, Ius Tamara, Simboli Giorgia A, Sabatino Giovanni
Institute of Neurosurgery, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy.
Institute of Neurosurgery, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy -
J Neurosurg Sci. 2019 Dec;63(6):656-660. doi: 10.23736/S0390-5616.19.04753-2. Epub 2019 Jul 23.
Indocyanine green video angiography (ICG-VA) is a non-invasive, easy to use and very useful tool for various neurosurgical procedures. The first application was in neurovascular surgery, because it was born as an intravascular tracer for vessels visualization; this has been really useful in aneurysms, atero-venous malformations (AVMs) and dural fistulas surgery where identification, obliteration or patency of vessels is essential. Introduced in vascular neurosurgery since 2003, ICG-VA applications have broadened over time, both in vascular and in other neurosurgical fields. In 2003 Raabe et al. have been the first to describe the use of ICG-VA for intraoperative assessment of cerebral vascular flow, enabling visualization of vessel patency and aneurysm occlusion during aneurysm surgery. ICG-VA applications in vascular neurosurgery have significantly increased over time including complex aneurysms, bypass, atero-venous malformations (AVM) artero-venous fistulas (AVF), evaluation of cortical perfusion. The procedure can be easily repeated after 5-10 minutes. Adverse reactions are comparable to those of other types of contrast media, with frequencies of 0.05% (hypotension, arrhythmia, or, more rarely, anaphylactic shock) to 0.2% (nausea, pruritus, syncope, or skin eruptions. The aim of the present study was to systematically analyze ICG-VA applications in vascular neurosurgery, highlighting the reported advantages and disadvantages, and discussing future perspectives.
吲哚菁绿视频血管造影术（ICG-VA）是一种用于各种神经外科手术的非侵入性、易于使用且非常有用的工具。其首次应用于神经血管外科手术，因为它最初是作为一种用于血管可视化的血管内示踪剂诞生的；这在动脉瘤、动静脉畸形（AVM）和硬脑膜动静脉瘘手术中非常有用，在这些手术中血管的识别、闭塞或通畅情况至关重要。自2003年引入血管神经外科以来，ICG-VA的应用随着时间的推移不断扩展，涵盖了血管和其他神经外科领域。2003年，拉贝等人首次描述了使用ICG-VA进行术中脑血管血流评估，能够在动脉瘤手术期间可视化血管通畅情况和动脉瘤闭塞情况。随着时间的推移，ICG-VA在血管神经外科的应用显著增加，包括复杂动脉瘤、搭桥手术、动静脉畸形（AVM）、动静脉瘘（AVF）以及皮质灌注评估。该操作可在5至10分钟后轻松重复进行。不良反应与其他类型的造影剂相当，发生率为0.05%（低血压、心律失常，或更罕见的过敏性休克）至0.2%（恶心、瘙痒、晕厥或皮肤疹）。本研究的目的是系统分析ICG-VA在血管神经外科的应用，突出已报道的优缺点，并探讨未来前景。
