title: Microsurgical clipping of intracranial aneurysms assisted by green indocyanine videoangiography (ICGV) and ultrasonic perivascular microflow probe measurement.
abstract: OBJECTIVE
  The purpose of this work is to assess the surgical and clinical outcome of intracranial aneurysm clipping performed combining the assistance of green indocyanine videoangiography (ICGV) and ultrasonic perivascular microflow probe.
  
  
  METHODS
  Data from patients affected with intracranial aneurysms who underwent microsurgical clipping assisted by both techniques between May 2012 and April 2013 were retrospectively evaluated.
  
  
  RESULTS
  26 patients with 34 aneurysms (25 unruptured) were enrolled. In a total of 11 aneurysms (32%), the vascular clip needed repositioning, since either the post-clipping microprobe assessment detected a significant flow reduction of the explored vessels (8 cases, 23%) or ICGV identified a residual non-obliterated aneurysm (3 cases, 9%). A second clip repositioning was required in 3 cases (9%) because of dome remnant showed with ICGV. In all cases, final microprobe and ICGV assessments showed a complete exclusion of the aneurysm, without evidence of vascular flow impairment. Postoperatively, 1 patient (3%) presented a residual neck aneurysm. No permanent morbidity was reported.
  
  
  CONCLUSIONS
  With the limits of our small case series, our results testify that the presented approach may provide high exclusion rate in the treatment of cerebral aneurysm with very low morbidity in selected patients.
authors.affiliation: Department of Neurosurgery, Padua University Hospital, Padova, Italy. Electronic address: alessandro.dellapuppa@sanita.padova.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Della Puppa
authors.affiliation: Department of Neurosurgery, Padua University Hospital, Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Volpin
authors.affiliation: Department of Neurosurgery, Padua University Hospital, Padova, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gioffre
authors.affiliation: Department of Neurosurgery, Padua University Hospital, Padova, Italy.
authors.forename: Oriela
authors.initials: O
authors.lastname: Rustemi
authors.affiliation: Department of Neurosurgery, Padua University Hospital, Padova, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Troncon
authors.affiliation: Department of Neurosurgery, Padua University Hospital, Padova, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Scienza
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D013525:Surgical Instruments; D014463:Ultrasonography
chemical_list: D007208:Indocyanine Green
keywords: Clipping; Green indocyanine videoangiography (ICGV); Intracranial aneurysm; Micro-surgery; Ultrasonic perivascular microflow probe