Indocyanine green videoangiography "in negative": definition and usefulness in intracranial dural arteriovenous fistulae

Neurosurgery. 2013 Sep;73(1 Suppl Operative):ons86-92; discussion ons92. doi: 10.1227/NEU.0b013e318282ddd6.


Background: Indocyanine green videoangiography (IGV) raises important limitations when we use it in vascular pathology, especially in cases with arterialization of the venous system such as arteriovenous malformations and fistulae.

Objective: Our objective was to provide a simple procedure that overcomes the limitations of conventional IGV. We define IGV in negative (IGV-IN), so-called because, in its first phase, the vessel to analyze is clipped, and we report 3 cases of intracranial dural arteriovenous fistulae treated with this procedure.

Methods: In 2011, we applied IGV-IN to 3 patients at our center with Borden type III intracranial arteriovenous fistulae.

Results: In all 3 cases, IGV-IN enabled both diagnosis and post-dural arteriovenous fistula exclusion control in 1 integrated procedure no longer than 1 minute, requiring only 1 visualization.

Conclusion: IGV-IN is an improvement over the conventional IGV method and is able to provide more information in a shorter period of time. It is an intuitive and highly visual procedure, and, more importantly, it is reversible. Studies with larger samples are necessary to determine whether IGV-IN can further reduce the need for postoperative digital subtraction angiography.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Adult
  • Central Nervous System Vascular Malformations / diagnostic imaging
  • Central Nervous System Vascular Malformations / surgery
  • Cerebral Angiography / methods*
  • Humans
  • Indocyanine Green*
  • Intracranial Arteriovenous Malformations / diagnostic imaging*
  • Intracranial Arteriovenous Malformations / surgery*
  • Male
  • Middle Aged
  • Video-Assisted Surgery / methods*


  • Indocyanine Green