+44 7480725689Mohsin Fayaz
Institute of Medical Sciences, Srinagar, Kashmir, India
ScientificTracks Abstracts: Res Rev Neurosci
Background: Digital subtraction angiography (DSA) is a fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. Images are produced using contrast medium by subtracting a ��?pre ��? contrast image� or mask from subsequent images, once the contrast medium has been introduced into a structure, hence the term ��?Digital subtraction angiography�. ICG video angiography-- is a safe and practical method of real time delineation of microvasculature used in the surgical management of intracranial aneurysms, arterio venous malformations and other vascular lesions. Intraoperative Indocyanine green video angiography (ICG - VA ) is used as an adjunct in addition to intraoperative or postoperative DSA, and in other cases, it is used as the sole method to confirm the complete obliteration of clipped intracranial aneurysm. The only limitation of ICG- VA is the non- visibility of vessels which are not in the operative field. Intraoperative ICG is useful in the clipping of intracranial aneurysms to ensure a gross patency of branch vessels; however, the presence of residual aneurysms and subtle changes in flow in branch vessels is best seen by DSA. Methods: Indocyanine green angiography was done during the surgery and the findings of intra operative ICG angiography were compared with post ��?operative DSA which was done between six to twelve weeks.DSA was done to see any compromise of lumen of parent vessel by clip, any residual aneurysm. Results: In our study intra-operative ICG complete aneurysm obliteration was present in all 30 (100%) patients while as in post-operative DSA complete aneurysm obliteration was diagnosed in 27 (90.0%) patients. Parent vessel patency was present in all 30 (100.0%) patients in both intra-operative ICG video-angiography and post ��?operative DSA .In intra-operative ICG distal branch patency was present in 26 (86.7%) patients while as in post operative DSA distal branch patency was diagnosed in 27 (90.0%) patients. Conclusion: We compared the intra-operative ICG finding and post-operative DSA finding and found that DSA is more sensitive than ICG in depicting residual aneurysm neck, hence reducing the risk of rupture of the aneurysm in future. Intra-operative ICG has high special resolution reflex feedback, intra-operative repositioning time is less and thus critical ischemia time is reduced. In a developing country like ours where DSA facilities are limited, ICG can be optimal investigation to delineate the vascular anatomy, confirmation of clip position thus reducing mortality. Key Words: Aneurysm, digital subtraction angiography, indocyanine video-angiography.
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