ICG Videoangiography in Neurosurgical Procedures

Indocyanine green videoangiography (ICG-VAG) has recently been used for neurosurgical procedures, and its usefulness and drawbacks were evaluated. ICG-VAG showed blood flow in the vessels as the hemodynamic change of ICG fluorescence intensity. In clipping cerebral aneurysms, preservation of blood flow in the parent and perforating arteries and occlusion of the aneurysm were recognized. In bypass surgery, the patency of blood flow from the graft was observed. In carotid endarterectomy, the precise stenosis area or residual stenosis was observed before or after surgery. In removal of arteriovenous malformation, the feeding arteries, draining veins, and the nidus were clearly demonstrated. In tumor surgery, tumor-related vessels, normal brain parenchyma vessels, bridging veins, and tumor margin infiltration were observed. These findings obtained using ICG-VAG were useful to achieve these surgeries safely and completely without complications associated with the use of ICG-VAG.