Journal Basic Info

  • Impact Factor: 1.989**
  • H-Index: 6
  • ISSN: 2637-4625
  • DOI: 10.25107/2637-4625
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Anesthesiology
  •  Minimal Invasive Surgery
  •  Oral & Maxillofacial Surgery
  •  Aesthetic & Cosmetic Surgery
  •  Gastroenterological Surgery
  •  Surgery & Surgical Research
  •  Breast Surgery
  •  Robotic Surgery

Abstract

Citation: World J Surg Surg Res. 2018;1(1):1017.DOI: 10.25107/2637-4625.1017

Comparison between Indocyanine-Green and Fluorescein for Cerebrovascular Surgery

Atsushi Saito

Department of Neurosurgery, Sendai Medical Center, Japan

*Correspondance to: Atsushi Saito 

 PDF  Full Text Research Article | Open Access

Abstract:

Purpose: Intraoperative Fluorescent Angiography (IFA) with two types of fluorescent dyes of Fluorescein (FS) and Indocyanine Green (ICG) is a useful tool for cerebrovascular surgery. We compared the two fluorescent dyes on the points of detection of perforators and application bypass surgery.
Methods: Intraoperative fluorescent angiography was performed with intraoperative observatory modules of microscope of OPMI PENTERO900 including two types of induction light for both of FS and ICG to evaluate the same fluorescent operative field for them. Fluorescent dyes of 250 mg of FS and ten times dilution of ICG were intravenously administered and quantitative analysis was performed with ROIs of software for movie analyzer. Objects for evaluation of perforators were 17 cases of cerebral aneurysms treated in our department from December 2015 to May 2016.
Results: Detection of perforators was evaluated in 6 cases of ruptured aneurysms and 11 cases of unruptured aneurysms. Location of aneurysms was as follows: 6 cases in anterior communicating artery, 4 cases in internal carotid artery-posterior communicating artery, and 7 cases in middle cerebral artery. Fluorescent intensity of perforators were evaluated with hypothalamic artery, lenticulostriate artery and branches from posterior communicating artery and that of main trunks was evaluated as objects with A1, A2, M1, and M2 portions. Averaged fluorescent intensity of FS was 78.3 ± 25.8 in perforators and 117.4 ± 22.2 in main trunks. Averaged fluorescent intensity of ICG was 29.2 ± 14.0 in perforators and 76.2 ± 40.0 in main trunks. The ratio of averaged fluorescent intensity to maximum fluorescent intensity, which indicated contrast of vascular structure on fluorescent angiography, was 2.97 times in FS and 1.98 times in ICG. Fluorescent angiography was applied to a case associated with postoperative hyper perfusion after superficial temporal arterymiddle cerebral artery bypass. Fluorescent intensity of cortex was markedly higher in FS than that of ICG just after bypass. Conclusions: Fluorescein was superior to detect perforators during clipping compared with ICG on both points of fluorescent intensity and contrast. Fluorescent angiography with FS might be superior to predict hyper perfusion after bypass surgery.

Keywords:

Cite the Article:

Saito A. Comparison between Indocyanine-Green and Fluorescein for Cerebrovascular Surgery. World J Surg Surgical Res. 2018; 1: 1017.

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