Use of Fluorescent Indocyanine Green Angiography During Microsurgical Resection of a Recurrent Giant Perimedullary Cervical Spinal Arteriovenous Fistula in a Patient with Hereditary Hemorrhagic Telangiectasia: A Case Report

Abstract

We report the utility of fluorescent indocyanine green (ICG) during the microsurgical resection of a giant perimedullary cervical arteriovenous fistula (GPMAVF) in a young man with hereditary hemorrhagic telangiectasia. ICG angiography is a useful adjunct for understanding angioarchitecture and drainage patterns in spinal arteriovenous malformation (AVM) surgery. Cervical GPMAVF is a rare spinal lesion found in association with hereditary hemorrhagic telangiectasia. This vascular malformation is associated with venous varices in a perimedullary location causing cord compression and vascular steal. This rare case highlights the crucial role of ICG during complex spinal AVM/AVF surgery to obtain angiographic cure.