title: Transdural indocyanine green video-angiography of vascular malformations.
abstract: BACKGROUND
  The role of indocyanine green video-angiography (ICG-VA) in the surgical resection of vascular malformations has been largely described; conversely, the utility of ICG-VA before dural opening (transdural ICG-VA) in this situation remains unclear. The aim of this study is to present the application of transdural ICG-VA in a consecutive series of patients in order to explore the potential provided by a transdural visualisation of vascular malformations.
  
  
  METHODS
  We retrospectively analysed the application of intra-operative ICG-VA before dural opening in 15 consecutive patients who underwent surgical resection of vascular malformations. The cases included 12 cerebral arterio-venous malformations (AVMs), 2 cerebral dural arterio-venous fistulas (dAVFs) and 1 spinal arterio-venous fistula (AVF).
  
  
  RESULTS
  ICG-VA before dural opening allowed the visualisation of the site and extension of the malformation in 13 out of 15 cases, whilst arterial feeders and venous drainages were identified in 9 out of 15 cases. In two patients with dAVF, the point of fistula could be transdurally identified through ICG-VA. In 14% of cases, the size of bone flap designed on neuronavigation data was then modified according to transdural ICG-VA findings.
  
  
  CONCLUSIONS
  Transdural ICG-VA proved an efficient tool that allows optimising the exposure of the malformation, performing a safe dural opening and identifying dural vascular connections of the lesion.
authors.affiliation: Department of Neurosurgery, Padua University Hospital of Azienda Ospedaliera di Padova, via Giustiniani, 2-35128, Padova, Italy, alessandro.dellapuppa@sanita.padova.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Della Puppa
authors.forename: Oriela
authors.initials: O
authors.lastname: Rustemi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gioffrè
authors.forename: Francesco
authors.initials: F
authors.lastname: Causin
authors.forename: Renato
authors.initials: R
authors.lastname: Scienza
mesh_terms: D000328:Adult; D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000601:surgery*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation; D061848:Optical Imaging; D012189:Retrospective Studies; D013116:Spinal Cord / Q000098:blood supply; D014656:Vascular Surgical Procedures; D014741:Video Recording
chemical_list: D007208:Indocyanine Green