Indocyanine green video-angiography as an aid to surgical treatment of spinal dural arteriovenous fistulae.
OBJECTIVE
To illustrate the use of indocyanine green (ICG) video-angiography to confirm abolition of spinal dural arteriovenous fistula (SDAVF) and preserve the normal vascular anatomy intraoperatively.


METHODS
A 73-year-old woman presenting with progressive myelopathy was diagnosed with an SDAVF, where the origin of the fistula was in close proximity to the origin of the posterior spinal artery. ICG was injected intravenously. Using a filter on the microscope, dynamic filling of the abnormal vasculature was visualised.


RESULTS
After applying a clip to the fistulous connection, we were able to see the successful interruption of the dural fistula, on-table in real time.


CONCLUSIONS
ICG video angiography confirmed interruption of the fistula and preservation of the associated posterior spinal artery. We find the application of this relatively new technology has the potential to shorten operating times, gives additional reassurance of completeness of surgical treatment and preservation of normal spinal vasculature.
Hettige
Samantha
S
Department of Neurosurgery, King's College Hospital, Denmark Hill, London SE5 9RS, UK. samanthahettige@hotmail.com
Walsh
Daniel
D
D000368:Aged; D000792:Angiography / Q000379:methods*; D001158:Arteries / Q000473:pathology / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D007431:Intraoperative Complications / Q000517:prevention & control; D007796:Laminectomy / Q000379:methods; D019635:Neurosurgical Procedures / Q000295:instrumentation; D011300:Preoperative Care; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013525:Surgical Instruments; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods; D014741:Video Recording / Q000379:methods*
D004396:Coloring Agents; D007208:Indocyanine Green