Application of intraoperative indocyanine green videoangiography in microsurgical clipping of ruptured posterior communicating artery aneurysms
Objective To investigate the application value of indocyanine green videoangiography(ICG-VA)in microsurgical clipping of ruptured posterior communicating artery aneurysms(PCoAA).Methods Patients with ruptured PCoAA underwent microsurgical clipping and intraoperative ICG-VA at the Department of Neurosurgery,Lianyungang First People's Hospital from January 2020 to July 2022 were included retrospectively.Head CT was reviewed 3 days after operation to determine perioperative complications.CT angiography(CTA)or digital subtraction angiography(DSA)were used to evaluate the monitoring effect of ICG-VA.Glasgow Outcome Scale(GOS)was used to evaluate the clinical outcomes.Results Thirty-two patients with ruptured PCoAA(a total of 38 aneurysms)were enrolled,including 7 males(21.9％),aged 57.97±8.91 years(range,40～73).Twenty-seven patients(84.4％)had single aneurysm and 5(15.6％)had multiple aneurysms(4 patients with 2 aneurysms and 1 with 3 aneurysms).Twenty-four patients(75.0％)had no or mild consciousness disorder,and 8(25.0％)had moderate to severe consciousness disorder.The aneurysms of all patients were successfully clipped and ICG-VA was performed for a total of 40 times.Five patients with multiple aneurysms underwent precise localization of the parent artery and aneurysmal body using ICG-VA before clipping.After initial clipping,ICG-VA found 3 cases of residual aneurysms.After adjusting or adding aneurismal clips,ICG-VA showed that the residues were eliminated.Three days after the surgery,CT scan showed that 1 patient had right subdural effusion with periventricular infarction,and 1 had subdural effusion.At the final follow-up,CTA or DSA showed no residual aneurysms;the GOS score of 18 patients(56.3％)were 5,5 patients(15.6％)were 4,and 9(28.1％)were 3.There were no cases of vegetative state or death.Conclusion ICG-VA assisted microsurgical clipping of ruptured PCoAA can effectively avoid residual aneurysms and the clinical application value is significant.
万方数据
维普
