• World Neurosurg · Oct 2022

    Indocyanine green endoscopy for pituitary adenomas with parasellar extension: results from a preliminary case series.

    • Matteo de Notaris, Matteo Sacco, Francesco Corrivetti, Iacopo Dallan, Luigi Maria Cavallo, Teresa Somma, Giovanni Parbonetti, Antonio Colamaria, and Domenico Solari.
    • Department of Neuroscience, Neurosurgery Operative Unit, "San Pio" Hospital, Benevento, Italy; Laboratory of Neuroscience, EBRIS Foundation, European Biomedical Research Institute of Salerno, Salerno, Italy. Electronic address: matteodenotaris@gmail.com.
    • World Neurosurg. 2022 Oct 1; 166: e692e702e692-e702.

    BackgroundAdvances in visualization tools have brought new confidence, including endoscope-integrated indocyanine (E-ICG), which makes pituitary and skull-base surgery safer and more effective. We report here our preliminary experience with the use of E-ICG to 1) visualize the cavernous segment of the internal carotid artery (ICA); and 2) functionally and anatomically preserve the pituitary gland.MethodsA dedicated ICG-integrated endoscope was used in 15 patients with parasellar pituitary adenomas. Indocyanine was administered at 2 different time points during surgery: an early bolus of 12.5 mg at the sphenoid sinus opening to expose the position of the parasellar segment of the ICAs and to identify the position of the normal pituitary gland so that it could be preserved during tumor removal. Subsequently, a second late bolus of 12 mg of ICG was injected to obtain a real-time "wire angiographic" visualization of the flow of the ICAs.ResultsGross total resection was achieved in 12 cases (80%), whereas subtotal resection was performed in the other 3 cases (20%). The pituitary gland was clearly discernable in 11 cases (91.6%). None of the patients manifested new endocrinologic deficits or major vascular complications.ConclusionsE-ICG is a safe and essential aid for pituitary adenomas invading the cavernous sinus. Its performance as a pituitary marker and real-time video angiography showed promising results in terms of extent of resection, endocrinologic outcomes, and prevention of intraoperative complications.Copyright © 2022 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…