Evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery

Neurosurg Rev. 2010 Apr;34(2):209-15. doi: 10.1007/s10143-010-0305-2. Epub 2011 Feb 8.


The primary aim of this study is to assess the value of intraoperative near-infrared indocyanine green videoangiography (ICGA) during intracranial aneurysm surgery. Altogether, 129 patients harboring 152 intracranial aneurysms were recruited in this study between March 2007 and December 2008 and the clinical data were retrospectively analyzed. Intraoperative ICGA was performed to examine the completeness of the aneurysm clipping and the patency of the parent arteries in all cases. The intraoperative findings were compared with that of postoperative digital subtraction angiography (DSA). On all of the patients, 276 successful ICGA investigations were performed intraoperatively. The image quality and resolution were excellent, allowing real-time assessment of the cerebral circulation. Indocyanine green (ICG) angiographic results could be divided into arterial, capillary, and venous phases, comparable to those observed with postoperative DSA. In all cases, the postoperative angiographic results corresponded to the intraoperative ICGA findings. In three cases, the information provided by intraoperative ICG angiography significantly changed the surgical procedure. Intraoperative ICG videoangiography may be a useful tool in real-time evaluation of the aneurysm clipping. Its simplicity and easy reproducibility all suggest it to be carried out as a routine procedure during aneurysm surgery.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiography, Digital Subtraction / instrumentation*
  • Cerebral Angiography / instrumentation*
  • Cerebral Arteries / pathology
  • Cerebral Arteries / surgery
  • Child
  • Coloring Agents
  • Female
  • Humans
  • Indocyanine Green / adverse effects
  • Intracranial Aneurysm / surgery*
  • Intraoperative Period
  • Male
  • Microsurgery / adverse effects
  • Microsurgery / instrumentation*
  • Middle Aged
  • Neurosurgical Procedures / instrumentation*
  • Postoperative Period
  • Spectroscopy, Near-Infrared
  • Subarachnoid Hemorrhage / surgery
  • Treatment Outcome
  • Video-Assisted Surgery / adverse effects
  • Video-Assisted Surgery / instrumentation*
  • Young Adult


  • Coloring Agents
  • Indocyanine Green