Venous sacrifice in neurosurgery: New insights from venous indocyanine green videoangiography - Clinical article

Research output: Contribution to journalArticle

Abstract

Object. The purpose of this paper is to evaluate whether venous indocyanine green (ICG) videoangiography has any potential for predicting the presence of a safe collateral circulation for veins that are at risk for intentional or unintentional damage during surgery. Methods. The authors performed venous ICG videoangiography during 153 consecutive neurosurgical procedures. On those occasions in which a venous sacrifice occurred during surgery, whether that sacrifice was preplanned (intended) or unintended, venous ICG videoangiography was repeated so as to allow us to study the effect of venous sacrifice. A specific test to predict the presence of venous collateral circulation was also applied in 8 of these cases. Results. Venous ICG videoangiography allowed for an intraoperative real-time flow assessment of the exposed veins with excellent image quality and resolution in all cases. The veins observed in this study were found to be extremely different with respect to flow dynamics and could be divided in 3 groups: 1) arterialized veins; 2) fast-draining veins with uniform filling and clear flow direction; and 3) slow-draining veins with nonuniform filling. Temporary clipping was found to be a simple and reversible way to test for the presence of potential anastomotic circulation. Conclusions. Venous ICG videoangiography is able to reveal substantial variability in the venous flow dynamics. "Slow veins," when they are tributaries of bridging veins, might hide a potential for anastomotic circulation that deserve further investigation.

Original languageEnglish
Pages (from-to)18-23
Number of pages6
JournalJournal of Neurosurgery
Volume115
Issue number1
DOIs
Publication statusPublished - Jul 2011

Fingerprint

Indocyanine Green
Neurosurgery
Veins
Collateral Circulation
Neurosurgical Procedures

Keywords

  • Cerebral veins
  • Cerebrovascular neurosurgery
  • Indocyanine green angiography
  • Surgical technique

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

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title = "Venous sacrifice in neurosurgery: New insights from venous indocyanine green videoangiography - Clinical article",
abstract = "Object. The purpose of this paper is to evaluate whether venous indocyanine green (ICG) videoangiography has any potential for predicting the presence of a safe collateral circulation for veins that are at risk for intentional or unintentional damage during surgery. Methods. The authors performed venous ICG videoangiography during 153 consecutive neurosurgical procedures. On those occasions in which a venous sacrifice occurred during surgery, whether that sacrifice was preplanned (intended) or unintended, venous ICG videoangiography was repeated so as to allow us to study the effect of venous sacrifice. A specific test to predict the presence of venous collateral circulation was also applied in 8 of these cases. Results. Venous ICG videoangiography allowed for an intraoperative real-time flow assessment of the exposed veins with excellent image quality and resolution in all cases. The veins observed in this study were found to be extremely different with respect to flow dynamics and could be divided in 3 groups: 1) arterialized veins; 2) fast-draining veins with uniform filling and clear flow direction; and 3) slow-draining veins with nonuniform filling. Temporary clipping was found to be a simple and reversible way to test for the presence of potential anastomotic circulation. Conclusions. Venous ICG videoangiography is able to reveal substantial variability in the venous flow dynamics. {"}Slow veins,{"} when they are tributaries of bridging veins, might hide a potential for anastomotic circulation that deserve further investigation.",
keywords = "Cerebral veins, Cerebrovascular neurosurgery, Indocyanine green angiography, Surgical technique",
author = "Paolo Ferroli and Francesco Acerbi and Giovanni Tringali and Erminia Albanese and Morgan Broggi and Angelo Franzini and Giovanni Broggi",
year = "2011",
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AU - Ferroli, Paolo

AU - Acerbi, Francesco

AU - Tringali, Giovanni

AU - Albanese, Erminia

AU - Broggi, Morgan

AU - Franzini, Angelo

AU - Broggi, Giovanni

PY - 2011/7

Y1 - 2011/7

N2 - Object. The purpose of this paper is to evaluate whether venous indocyanine green (ICG) videoangiography has any potential for predicting the presence of a safe collateral circulation for veins that are at risk for intentional or unintentional damage during surgery. Methods. The authors performed venous ICG videoangiography during 153 consecutive neurosurgical procedures. On those occasions in which a venous sacrifice occurred during surgery, whether that sacrifice was preplanned (intended) or unintended, venous ICG videoangiography was repeated so as to allow us to study the effect of venous sacrifice. A specific test to predict the presence of venous collateral circulation was also applied in 8 of these cases. Results. Venous ICG videoangiography allowed for an intraoperative real-time flow assessment of the exposed veins with excellent image quality and resolution in all cases. The veins observed in this study were found to be extremely different with respect to flow dynamics and could be divided in 3 groups: 1) arterialized veins; 2) fast-draining veins with uniform filling and clear flow direction; and 3) slow-draining veins with nonuniform filling. Temporary clipping was found to be a simple and reversible way to test for the presence of potential anastomotic circulation. Conclusions. Venous ICG videoangiography is able to reveal substantial variability in the venous flow dynamics. "Slow veins," when they are tributaries of bridging veins, might hide a potential for anastomotic circulation that deserve further investigation.

AB - Object. The purpose of this paper is to evaluate whether venous indocyanine green (ICG) videoangiography has any potential for predicting the presence of a safe collateral circulation for veins that are at risk for intentional or unintentional damage during surgery. Methods. The authors performed venous ICG videoangiography during 153 consecutive neurosurgical procedures. On those occasions in which a venous sacrifice occurred during surgery, whether that sacrifice was preplanned (intended) or unintended, venous ICG videoangiography was repeated so as to allow us to study the effect of venous sacrifice. A specific test to predict the presence of venous collateral circulation was also applied in 8 of these cases. Results. Venous ICG videoangiography allowed for an intraoperative real-time flow assessment of the exposed veins with excellent image quality and resolution in all cases. The veins observed in this study were found to be extremely different with respect to flow dynamics and could be divided in 3 groups: 1) arterialized veins; 2) fast-draining veins with uniform filling and clear flow direction; and 3) slow-draining veins with nonuniform filling. Temporary clipping was found to be a simple and reversible way to test for the presence of potential anastomotic circulation. Conclusions. Venous ICG videoangiography is able to reveal substantial variability in the venous flow dynamics. "Slow veins," when they are tributaries of bridging veins, might hide a potential for anastomotic circulation that deserve further investigation.

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KW - Cerebrovascular neurosurgery

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KW - Surgical technique

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