title: Indocyanine green videoangiography "in negative": definition and usefulness in spinal dural arteriovenous fistulae.
abstract: OBJECTIVE
  Indocyanine green videoangiography (IGV) has proven its effectiveness in the field of exovascular neurosurgery, both in the intracranial and spinal compartment, but is necessary to define a systematic process for the performance of the IGV to facilitate its interpretation during the procedure. We have defined and applied the concept of videoangiography "in negative" (INIGV) to spinal dural arteriovenous fistulae (dAVF) for the detection and treatment of arteriovenous shunts, so called because the first phase is performed with the vessel suggestive of being pathological occluded.
  
  
  METHODS
  A Pentero-operating microscope with near-infrared IGV-integrated system (Carl Zeiss Co., Germany) was used. At our institution, 24 patients were treated for a spinal dAVF between 1995 and 2011, only in the last 4 cases, INIGV was performed.
  
  
  RESULTS
  We describe the IGV in negative procedure and show the most illustrative cases. In all cases, the fistula occlusion was confirmed by postoperative selective digital subtraction angiography (DSA). INIGV demonstrate its capacity in detecting vessels not actually arterialized that should be respected and avoid some of the main limitations of the conventional IGV. This is a technical description about an Indocyanine green (ICG) videoangiographic procedure modification that is superior to merely performing ICG before and after clipping of a dAVF.
  
  
  CONCLUSIONS
  The INIGV results are rapid and easy to interpret procedure and provide great advantages to the dAVF treatment. Nevertheless, further studies are needed with a larger sample size to determine if INIGV may reduce the need to perform immediate postoperative DSA.
authors: Neurosurgical Department, HUyP La Fe de Valencia, Blv Sur, S/N., Valencia, Spain. juanantonio.simal@gmail.com
authors: Juan Antonio
authors: JA
authors: Simal Julián
authors: Pablo
authors: P
authors: Miranda Lloret
authors: Antonio
authors: A
authors: López González
authors: Rocío
authors: R
authors: Evangelista Zamora
authors: Carlos
authors: C
authors: Botella Asunción
mesh_terms: D000792:Angiography / Q000379:methods*; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000601:surgery; D004396:Coloring Agents; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D013116:Spinal Cord / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D014741:Video Recording / Q000379:methods
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green