The Correlation Between the Intraoperative Employment of Indocyanine Green Videoangiography and Incidences of Residual Aneurysm and Parent Vessel Trauma: A Retrospective Analysis from a Single Centre

Abstract

Abstract Background Mitigating residual cerebral aneurysm and parent artery trauma during the microsurgical treatment of aneurysms, specifically clipping, is of paramount importance to enhance patient outcomes. This study examines the effectiveness of intraoperative indocyanine green-videoangiography as a strategic tool to attenuate these surgical complications. Materials and Methods We conducted a retrospective analysis of patient medical records who underwent cerebral aneurysm surgery in our institution from January 2012 to July 2018. The characteristic variables were juxtaposed between cohorts who had undergone intraoperative ICG-VA and those who had not, employing the independent-samples Student’s t-test and Chi-square test for statistical comparison. The Sindou grading system was utilized to categorize aneurysm remnants, while injury to the parent artery was determined jointly by a neurosurgeon and a neuroradiologist. Logistic regression models were utilized to investigate the correlation between intraoperative ICG-VA usage and the presence of aneurysm remnants and parent artery injury. Results A total of 127 patients, harboring 131 aneurysms, underwent surgical treatment. Among these patients, 55 had intraoperative ICG-VA utilized. The occurrence rates of residual aneurysm and parent artery injury were documented at 30.5% and 6.9%, respectively. With regards to the Sindou grade I–III aneurysm remnants, interpreted as favorable outcomes, such results were observed in 14 (82.4%) patients in the non-ICG-VA group and 21 (91.3%) patients in the ICG-VA group, with no significant difference discerned between the two groups (p = 0.406; odds ratio [OR], 2.250; 95% confidence interval [CI], 0.332–15.236). Without parent artery injury, there were 64 (88.9%) patients in the non-ICG-VA group and 58 (98.3%) patients in the ICG-VA group, presenting a significant difference (p = 0.038; OR, 10.793; 95% CI, 1.134–102.691). Conclusions The utilization of intraoperative ICG-VA during microsurgical aneurysm clipping could notably decrease the incidence of parent artery injury. Nonetheless, when considering the presence of aneurysm remnants, the expertise of the neurosurgeon may play a more influential role compared to the use of ICG-VA.