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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Surg. | doi: 10.3389/fsurg.2019.00059

Applications of microscope-integrated indocyanine green videoangiography in cerebral revascularization procedures.

  • 1Barrow Neurological Institute (BNI), United States

Indocyanine green videoangiography (ICG-VA) is a near-infrared range fluorescent marker used for intraoperative real-time assessment of flow in cerebrovascular surgery. Given its high spatial and temporal resolution, ICG-VA has been widely established as a useful technique to perform a qualitative analysis of the graft patency during revascularization procedures. In addition, this fluorescent modality can also provide valuable qualitative and quantitative information regarding the cerebral blood flow within the bypass graft and in the territories supplied. Digital subtraction angiography (DSA) is considered to be the gold standard diagnostic modality for postoperative bypass graft patency assessment. However, this technique is time and labor intensive and an expensive interventional procedure. In contrast, ICG-VA can be performed intraoperatively, with no significant addition to the total operative time and when used correctly, can accurately diagnose an immediate occlusion. Such time-sensitive ischemic injury detection is critical for flow re-establishment through direct surgical management. In addition, ICG has an excellent safety profile with minimal adverse events reported in the literature. This review aims to provide an outline of the chemical behavior, technical aspects and clinical implications of this tool as an intraoperative adjunct in revascularization procedures.

Keywords: indocyanin green video angiography, Cerebral Revascularization, Extracranial (EC)–intracranial (IC), Graft patency, Intracranial (IC)-intracranial (IC)

Received: 14 May 2019; Accepted: 02 Oct 2019.

Copyright: © 2019 Cavallo, Gandhi, Zhao, Belykh, Valli, Nakaji, Preul and Lawton. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Michael T. Lawton, Barrow Neurological Institute (BNI), Phoenix, 85013, Arizona, United States, michael.lawton@barrowbrainandspine.com