title: Intraoperative indocyanine green videoangiography for spinal vascular lesions: case report.
abstract: BACKGROUND
  In surgery of spinal vascular lesions such as spinal arteriovenous fistula or vascular tumors, assessment of feeding arteries and draining veins is important. Intraoperative digital subtraction angiography is useful but is invasive and sometimes technically demanding. Near-infrared indocyanine green (ICG) videoangiography is less invasive and has been reported as an intraoperative diagnosis of arterial patency during clipping surgery of cerebral aneurysms or bypass surgeries. We present our experience with intraoperative ICG videoangiography in 3 cases of spinal vascular lesions.
  
  
  METHODS
  Two patients had spinal arteriovenous fistula (perimedullary, n = 1; dural, n = 1), and 1 patient had spinal cord hemangioblastoma at the thoracic or thoracolumbar level. The surgical microscope was an OPMI Pentero (Carl Zeiss, Oberkochen, Germany). After laminectomy and opening of the dura, ICG (5 mg) was injected intravenously. The ICG angiography clearly demonstrated feeding and draining vessels. The ICG findings greatly helped successful interruption of arteriovenous fistula and total removal of the tumor.
  
  
  CONCLUSIONS
  Intraoperative ICG videoangiography for spinal vascular lesions was useful by providing information on vascular dynamics directly. However, the diagnostic area is limited to the field of the surgical microscope. Although intraoperative digital subtraction angiography is still needed in cases of complex spinal vascular lesions, ICG videoangiography will be an important diagnostic modality in the field of spinal vascular surgeries.
authors.affiliation: Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan. tomohiro@sapmed.ac.jp
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Murakami
authors.forename: Izumi
authors.initials: I
authors.lastname: Koyanagi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kaneko
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iihoshi
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
mesh_terms: D000328:Adult; D006801:Humans; D007208:Indocyanine Green; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000379:methods; D014742:Videodisc Recording / Q000379:methods
chemical_list: D007208:Indocyanine Green