Abstract
Intraoperative angiography (IOA) has proven to be a safe and effective adjunct to surgical repair of cerebral aneurysms. Substantial practice variation exists regarding use of this modality in different centers, including use of IOA routinely, selectively, or rarely. In this editorial, we discuss our experience and review the existing literature to develop an argument for routine use of IOA during cerebral aneurysm surgery.
Highlights
Intraoperative angiography (IOA) has been considered since the 1960s for use during surgical repair of cerebral aneurysms
Without IOA, the surgeon's only means to confirm complete aneurysm occlusion is to puncture the aneurysm dome – an incompletely occluded aneurysm will hemorrhage from the puncture site, which not usually problematic is certainly not an optimal means to discover incomplete aneurysm occlusion
While surgical repair of large and/or complex aneurysms carries a higher likelihood of findings on IOA leading to clip revision, even experienced surgeons cannot adequately predict the need for IOA on a selective basis
Summary
Intraoperative angiography (IOA) has been considered since the 1960s for use during surgical repair of cerebral aneurysms. The potential to confirm complete aneurysm occlusion and patency of the parent vasculature intraoperatively are the key clinical uses that underlie IOA. No consensus exists regarding routine use of IOA in cerebral aneurysm surgery.
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