Role of Intra Operative Near Infrared Indocyanine Green Videoangiography in Neurosurgery: An Initial Experience

Received, 20 October, 2013 Accepted, 4 November, 2013 Fluorescence angiography incorporated in microscope not only helps to identify vessels and vascular pathology but also ensures patency and adequacy of procedure like clipping of aneurysm or excision of AVM. Despite this technical advancement, cost and availability prohibits its extensive use in a developing country like ours. We here present our initial experience with intra-operative near infrared indocyanine green videoangiography (ICGA) and discuss its role in neurosurgery. A retrospective study enrolling patients with neurovascular pathology over last 2 months was performed. Endpoints included were adequacy of procedure, complications, cost and ease of application. IOFA was used in 15 patients, included were clipping of aneurysm (CA) (66.7%), tumor excision (TU) (13.6%), microvascular decompression (MVD) (13.3%) and arterio-venous malformation excision (AVM) (6.6%). ICGA cost Rupees 3000 extra (cost of dye) to patient but ensured adequacy of procedure (complete occlusion of aneurysm, excision of AVM, and decompression of nerve), patency of perforators, en passage vessels and veins and identify feeders without additional complications. Total procedure got prolonged by mean of 15 minutes. ICGA is a safe, viable, useful technique to identify vascular anatomy as well as confirm adequacy of procedure without significant complications. This tool to summarize, boost surgical precision and is cost effective.