The application of indocyanine green fluorescence imaging in aneurysm surgery

Objective To investigate the role of indocyanine green(ICG)fluorescence imaging in craniotomy aneurysm clipping. Methods A retrospective study was performed on 58 cases of patients with intracranial aneurysm who were admitted and treated by craniotomy from March 2013 to March 2015.ICG fluorescence angiography was used in 26 cases during operation(imaging surgery group)and no intraoperative ICG fluorescence angiography was performed in 32 cases(conventional surgery group). Through ICG fluorescence angiography to assist determine clipping position by evaluating the direction of aneurysm, size of occlusion, and the blood supply of its parent artery.The coma scale of the patients was evaluated by the glass coma scale(GCS), and the postoperative cerebral ischemia and aneurysm residual were compared between the two groups. Results All patients were followed up by 3 to 10 months.GCS score of the imaging surgery group, 25 cases in level 1, and 1 case in level 2.GCS score of the conventional surgery group, 29 cases in level 1, and 3 cases in level 2.The incidence of cerebral ischemia and residual aneurysm in the imaging surgery group was significantly lower than that in the conventional surgery group, and the difference was statistically significant(P<0.05). Conclusion The technique of intracranial aneurysm ICG imaging is simple and easy to operate.It has features of ideal spatial resolution and temporal resolution, high safety, and strong repeatability.By providing important information about whether aneurysm neck is completely closed, whether the parent artery is stenotic, and whether important branches of artery are open. Key words: Indocyanine green; Fluorescence imaging; Craniotomy clipping aneurysm