title: Intra-arterial injection fluorescein videoangiography in aneurysm surgery.
abstract: BACKGROUND
  To visualize blood flow in the arteries and aneurysm during surgery, intravenous fluorescence videoangiography has been used. However, the image contrast with this procedure is diminished by repeated study because the dye remains for about 10 minutes after injection.
  
  
  OBJECTIVE
  To determine the optimal dye concentration and to clarify the usefulness of fluorescein videoangiography by intra-arterial dye injection.
  
  
  METHODS
  In the pilot study, fluorescein sodium dissolved at various concentrations was illuminated with excitation light, and fluorescence was detected by cameras. The fluorescence of 0.001% fluorescein sodium solution mixed with plasma at various concentrations was then examined. In 13 aneurysm patients, dye solution was administered through the catheter for intraoperative digital subtraction angiography. The intravenous injection method was also performed, and the findings were compared.
  
  
  RESULTS
  Dye was clinically used at a concentration of 0.005% to 0.1% on the basis of the results of the pilot study. Fluorescence emission from the vessels and aneurysms was clearly observed by both methods; however, arterial injection provided brighter emission, resulting in clearer demonstration of the bloodstream than venous injection. Dye clearance was also quicker, which allowed repeat injections without delay. Dye filling in the aneurysm indicating incomplete occlusion was detected in 2 cases, and occlusion of the perforating artery was observed in 2 cases.
  
  
  CONCLUSIONS
  Intra-arterial fluorescein videoangiography provides brighter and clearer imaging of blood flow with a smaller dose of dye than intravenous videoangiography. It can be repeated within a short time and is useful for detecting incomplete clipping or unexpected obstruction of arteries.
authors.affiliation: Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Kuroda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kinouchi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kanemaru
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nishiyama
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ogiwara
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Toru
authors.initials: T
authors.lastname: Horikoshi
mesh_terms: D002533:Cerebral Angiography / Q000379:methods*; D019793:Fluorescein / Q000008:administration & dosage; D005451:Fluorescein Angiography / Q000379:methods*; D005456:Fluorescent Dyes / Q000008:administration & dosage; D006801:Humans; D007269:Injections, Intra-Arterial; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D014741:Video Recording
chemical_list: D005456:Fluorescent Dyes; D019793:Fluorescein