Objective To study the application of intraoperative near - infrared indocyanine green videoangiography and visual analysis of blood flow dynamics in cerebral aneurysm clipping surgery,and analyze the advantages and limitations.Methods 47 patients with 51 intracranial aneurysms were treated by microsurgical clipping.Intraoperative ICG videoangiography was performed before or/and after clip application.The infrared fluorescence module integrated into the surgical microscope was used to visualize fluorescent areas in surgical field and permitted the recording of a video of the emitted fluorescent light.The recorded video signal was then constantly analyzed by an integrated analytical visualization tool for rapid interpretation of the fluorescence video sequences with intensity diagram.Results All of the images provided high resolution allowing real time assessment of the blood flow of parent artery,arterial branches or small perforators.Incomplete clipping of 4 anearysms were detected by using ICG angiography.Perforating arteries arising closed to or from aneurysmal neck were identified in the surgical eid of 15 aneurysms and the ICG angiography allowed real time assessment of the blood flow.The intensity diagram of ICG angiography provided important imformation in three cases.Conclusions ICG video angiography could provide high resolution images allowing real time assessment of the blood flow of parent artery,arterial branches or small perforators to improve the outcome of intracranial aneurysm surgery.The intensity diagram function is useful as an adjunct to ICG video angiography for documenting the blood flow.
Key words:
Intracranial aneurysm; Indocyanine green; Angiograpny; Microsurgery
Objective To present our experience with retrograde suction decompression in clipping of large and giant internal carotid artery aneurysms and analyze its advantages and pitfalls.Methods A retrospective analysis of 26 large and giant intracranial aneurysms treated by suction decompression assisted clipping between November 2005 and February 2010 was present.The surgical techniques and the outcome of patients were reviewed.Results All aneurysms were successfully clipped, and postoperative 3D - CTA or DSA revealed no major branch occlusion or residual aneurysm.There was no surgical mortality in both giant and large aneurysm groups.Conclusions Retrograde suction decompression is a successful adjunct to clipping of large and giant internal carotid artery aneurysms.
Key words:
Aneurysm; Internal carotid artery; Retrograde suction decompression
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