Safety Efficacy and Cost of Intraoperative Indocyanine Green Angiography Compared to Intraoperative Catheter Angiography in Cerebral Aneurysm Surgery

Department

neurosurgery

Document Type

Article

Abstract

Intraoperative angiography in cerebrovascular neurosurgery can drive the repositioning or addition of aneurysm clips. Our institution has switched from a strategy of intraoperative digital subtraction angiography (DSA) universally, to a strategy of indocyanine green (ICG) videoangiography with DSA on an as-needed basis. We retrospectively evaluated whether the rates of perioperative stroke, unexpected postoperative aneurysm residual, or parent vessel stenosis differed in 100 patients from each era (2002, \"DSA era\"; 2007, \"ICG era\"). The clip repositioning rate for neck residual or parent vessel stenosis did not differ significantly between the two eras. There were no differences in the rate of perioperative stroke or rate of false-negative studies. The per-patient cost of intraoperative imaging within the DSA era was significantly higher than in the ICG era. The replacement of routine intraoperative DSA with ICG videoangiography and selective intraoperative DSA in cerebrovascular aneurysm surgery is safe and effective. © 2014 Published by Elsevier Ltd.

Publication Date

2014

Publication Title

Journal of Clinical Neuroscience

ISSN

0967-5868

Volume

21

Issue

8

First Page

1377

Last Page

1382

Digital Object Identifier (DOI)

10.1016/j.jocn.2014.02.006

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