Pol. Merkur. Lek (Pol. Med. J.), 2019, XLVII/281: 183-186 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2019, XLVII/281: 183-186

Title: Intraoperative fluorescein videoangiography in cerebral aneurysm surgery – a preliminary study 

Authors: Świątnicki W, Komuński P. 

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Intraoperative fluorescein videoangiography in cerebral aneurysm surgery – a preliminary study

Świątnicki W, Komuński P.

Department of Neurosurgery, Regional Medical Center, Maria Skłodowska-Curie Hospital, Zgierz, Poland

One of the most important challenges in intracranial aneurysm surgery is safe and correct clip deployment. Various methods have been developed in order to improve surgeon’s intraoperative confidence and provide real-time information about the efficacy of clipping. Sodium fluorescein video angiography, however, was not well studied so far.
The aim of the study
was to evaluate the accuracy of FLuorescein Video Angiography (FL-VA) performed intraoperatively during intracranial aneurysm surgery in demonstrating complete occlusion of the aneurysm sac while preserving the patency of parent, branching, and perforating arteries.
Materials and methods
. This is a prospective study based on a series of 41 consecutive patients harboring 43 aneurysms. All patients underwent surgical clipping followed by intraoperative, intravenous administration of 200 mg bolus of sodium fluorescein dye. After surgery, CTA was performed in order to identify any aneurysm remnant or signs of cerebral ischemia in the territory of branching arteries adjacent to clip.
. Intraoperative FL-VA led to clip reposition in 16,3%. This technology is very simple to use, cost-effective and intuitive in terms of interpretation of real-time, high quality images derived intraoperatively without the need to interrupt microsurgery. It provides a surgeon with additional confidence and real-time data enabling to adjust clip position in order to avoid potentially severe complications.
. Based on our preliminary experience we believe that fluorescein video angiography has a safe profile and is very useful in cerebral aneurysm surgery.

Key words: intracranial aneurysm, fluorescein, microneurosurgery

Pol Med J, 2019; XLVII (281); 183–186