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A Pilot Comparison of Multispectral Fluorescence to Indocyanine Green Videoangiography and Other Modalities for Intraoperative Assessment in Vascular Neurosurgery
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A Pilot Comparison of Multispectral Fluorescence to Indocyanine Green Videoangiography and Other Modalities for Intraoperative Assessment in Vascular Neurosurgery
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A Pilot Comparison of Multispectral Fluorescence to Indocyanine Green Videoangiography and Other Modalities for Intraoperative Assessment in Vascular Neurosurgery
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Journal Article
A Pilot Comparison of Multispectral Fluorescence to Indocyanine Green Videoangiography and Other Modalities for Intraoperative Assessment in Vascular Neurosurgery
2019
Overview
Abstract
BACKGROUND
Digital subtraction angiography (DSA) is the gold standard for vascular imaging, but is not easily integrated into a continuous microsurgical environment. Other available modalities for intraoperative vascular assessment have their own limitations.
OBJECTIVE
To investigate multispectral fluorescence (MFL), a new technology based on indocyanine green (ICG) fluorescence, which may provide advantages over current intraoperative imaging modalities.
METHODS
Cadaveric intracranial aneurysm models and turkey wing bypasses were created and tested with white light and micro-Doppler ultrasound, indocyanine green videoangiography (ICG-VA), MFL, and DSA in conditions mimicking surgery. Assessments with these modalities were scored by 7 neurosurgeons.
RESULTS
DSA was significantly better than other modalities in evaluating the vasculature (P < .0001), but was significantly less ergonomic and efficient (P < .0001). MFL and ICG-VA were not significantly different from each other. Both were significantly better than white light/micro-Doppler ultrasound in assessing occlusion and patency (P ≤ .011), and both were better than DSA in ergonomics and efficiency (P < .0001).
CONCLUSION
MFL performs similarly to ICG-VA in a laboratory setting. Further study will be required to determine whether it compares favorably in the operating room. While DSA is the standard for cerebrovascular visualization, MFL and ICG are significantly more ergonomic and efficient.
Publisher
Oxford University Press,Wolters Kluwer Health, Inc
Subject
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