• Alberto Feletti, Xiangdong Wang, Riki Tanaka, Yasuhiro Yamada, Daisuke Suyama, Tsukasa Kawase, Hirotoshi Sano, and Yoko Kato.
• Department of Neurosciences, Neurosurgery Unit, NOCSAE Modena Hospital, Modena, Italy; Department of Neurosurgery, Fujita Health University Hospital, Nagoya, Japan. Electronic address: alberto.feletti@gmail.com.
• World Neurosurg. 2017 Mar 1; 99: 572-579.

ObjectiveIndocyanine green videoangiography (ICG-VA) is a valuable tool to assess vessel and aneurysm patency during neurovascular surgical procedures. However, ICG-VA highlights vascular structures, which appear white over a black background. Anatomic relationships are sometimes difficult to understand at first glance. Dual-image videoangiography (DIVA) enables simultaneous visualization of light and near-infrared fluorescence images of ICG-VA.MethodsThe DIVA system was mounted on an OPMI Pentero Flow 800 intraoperative microscope. DIVA was used during microsurgical procedures on 5 patients who were operated for aneurysm clipping and superficial temporal artery-middle cerebral artery bypass.ResultsDIVA provides real-time simultaneous visualization of aneurysm and vessels and surrounding structures including brain, nerves, and surgical clips. Although visual contrast between vessels and background is higher with standard black-and-white imaging, DIVA makes it easier to understand anatomic relationships between intracranial structures. DIVA also provides better vision of the depth of field.ConclusionsDIVA has the potential to become a widely used intraoperative tool to check patency of intracranial vessels. It should be considered as an adjunct to standard ICG-VA for better understanding of vascular anatomy in relation to surrounding structures and can have an impact on decision making during surgery.Copyright © 2016 Elsevier Inc. All rights reserved.

34 keywords...

hide…