Abstract
BackgroundIndocyanine green video angiography (ICG–VA) is a safe and effective instrument to assess changes in cerebral blood flow during cerebrovascular surgery. After ICG-VA, FLOW 800 provides a color-coded map to directly observe the dynamic distribution of blood flow and to calculate semiquantitative blood flow parameters later. The purpose of our study is to assess whether FLOW 800 is useful for surgery of complex intracranial aneurysms and to provide reliable evidence for intraoperative decision-making.MethodsWe retrospectively reviewed patients with complex aneurysms that underwent microsurgical and intraoperative evaluation of ICG-VA and FLOW 800 color-coded maps from February 2019 to May 2020. FLOW 800 data were correlated with patient characteristics, clinical outcomes, and intraoperative decision-making.ResultsThe study included 32 patients with 42 complex aneurysms. All patients underwent ICG-VA FLOW 800 data provided semiquantitative data regarding localization, flow status in major feeding arteries; color maps confirmed relative adequate flow in parent, branching, and bypass vessels.ConclusionsFLOW 800 is a useful supplement to ICG-VA for intraoperative cerebral blood flow assessment. ICG-VA and FLOW 800 can help to determine the blood flow status of the parent artery after aneurysm clipping and the bypass vessels after aneurysm bypass surgery.
Highlights
Indocyanine green video angiography (ICG–VA) is a safe and effective instrument to assess changes in cerebral blood flow during cerebrovascular surgery
Patient and aneurysm characteristics A total of 32 consecutive patients with 42 complex aneurysms were enrolled in this study
Thereof, 16 patients were treated for unruptured aneurysms and 16 patients with subarachnoid hemorrhage (SAH) were treated for a ruptured aneurysm
Summary
Indocyanine green video angiography (ICG–VA) is a safe and effective instrument to assess changes in cerebral blood flow during cerebrovascular surgery. Complex cerebral aneurysms contain giant aneurysms (greater than 25 mm in diameter) and some aneurysms characterized by large (15–25 mm), difficult locations, previous treatment, presence or absence of collateral circulation, intraluminal thrombus, and (2021) 7:28 trapping with or without flow replacement (bypass), primary proximal vessel occlusion (Hunterian ligation), and distal vessel occlusion can be used [4]. The complexity of these aneurysms often makes the operation more difficult, and they are accompanied by a high occurrence of complications. The purpose of this study was to present our single-center experience with the application of intraoperative ICG-VA and hemodynamic analysis with FLOW 800 in complex intracranial aneurysms
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