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首页> 外文期刊>Neurosurgery >Near-infrared Indocyanine Green Video Angiography: A New Method for Intraoperative Assessment of Vascular Flow.
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Near-infrared Indocyanine Green Video Angiography: A New Method for Intraoperative Assessment of Vascular Flow.

机译：近红外吲哚菁绿视频血管造影术：术中评估血管血流的新方法。

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OBJECTIVE: We report our initial clinical experience with a new method for intraoperative blood flow assessment. The purposes of the study were to assess the use of indocyanine green (ICG) video angiography in neurovascular cases, to assess the handling and image quality, to compare the findings with postoperative angiographic results, and to evaluate the clinical value of the method in a preliminary feasibility study. METHODS: Fourteen patients with aneurysms (n = 12) or spinal (n = 1) or intracranial (n = 1) dural fistulae were included. Before and/or after aneurysm or dural fistula occlusion, ICG (25 mg) was injected intravenously. A near-infrared laser excitation light source (lambda = 780 nm) illuminated the operating field. The intravascular fluorescence of ICG (maximal lambda = 835 nm) was recorded by a nonintensified video camera, with optical filtering to block ambient and laser light for collection of only ICG-induced fluorescence. RESULTS: A total of 21 investigations were performed for 14 patients. For the 17 successful ICG video angiographic investigations, image quality and resolution were excellent, allowing intraoperative real-time assessment of the cerebral circulation. ICG angiographic results could be divided into arterial, capillary, and venous phases, comparable to those observed with digital subtraction angiography. In all cases, the postoperative angiographic results corresponded to the intraoperative ICG video angiographic findings. In three cases, the information provided by intraoperative ICG angiography significantly changed the surgical procedure. CONCLUSION: ICG video angiography is simple and provides real-time information on the patency of arterial and venous vessels of all relevant diameters, including small and perforating arteries (<0.5 mm), and the visible aneurysm sac. It may be a useful adjunct to improve the quality of neurovascular procedures and to document the intraoperative vascular flow.
机译：目的：我们报告了一种新的术中血流评估方法的初步临床经验。该研究的目的是评估在神经血管疾病中使用吲哚菁绿（ICG）视频血管造影，评估处理和图像质量，将结果与术后血管造影结果进行比较以及评估该方法在临床上的临床价值。初步可行性研究。方法：纳入14例患有动脉瘤（n = 12）或脊髓（n = 1）或颅内（n = 1）硬膜瘘的患者。在动脉瘤或硬脑膜瘘闭塞之前和/或之后，静脉注射ICG（25 mg）。近红外激光激发光源（λ= 780 nm）照亮了操作场。用非增强型摄像机记录ICG的血管内荧光（最大λ= 835 nm），并进行光学过滤以阻挡环境和激光，仅收集ICG诱导的荧光。结果：共对14例患者进行了21次检查。对于17项成功的ICG视频血管造影检查，其图像质量和分辨率都非常出色，可以在术中实时评估脑循环。 ICG血管造影结果可分为动脉期，毛细血管期和静脉期，与数字减影血管造影所观察到的结果相当。在所有情况下，术后血管造影结果均与术中ICG视频血管造影结果相符。在三种情况下，术中ICG血管造影所提供的信息显着改变了手术程序。结论：ICG视频血管造影非常简单，可实时提供有关所有相关直径的动脉和静脉血管通畅性的实时信息，包括小动脉和穿孔动脉（<0.5 mm）以及可见的动脉瘤囊。改善神经血管手术的质量并记录术中血管流量可能是有用的辅助手段。

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