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Vol. 21. Issue 4.
Pages 302-305 (January 2010)
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Vol. 21. Issue 4.
Pages 302-305 (January 2010)
Videoangiografía intraoperatoria con verde de indocianina durante la cirugía de aneurismas cerebrales. Experiencia inicial en 10 intervenciones quirúrgicas
Intraoperative videoangiography using green indocyanine during aneurysm surgery
Visits
1907
J. Macho*
*. Servicio de Neurocirugía. Servicio de Neuroangiorradiología
R. Valero**
** Servicio de Anestesiología
E. Cordero
, J. Enseñat, J.J. González, M. Sánchez, C. Fernández, L. Caral, E. Ferrer
Hospital Clinic i Provincial de Barcelona
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Resumen
Objetivo

El objetivo de los autores es reportar nuestra experiencia inicial sobre la utilización de la videoangiografía intraoperatoria con verde de indocianina durante la cirugía de aneurismas cerebrales en nuestro centro.

Material y métodos

Se han realizado 10 procedimientos quirúrgicos en 9 pacientes, 5 varones y 4 mujeres entre 27 y 61 años con una media de edad de 49 años durante un tiempo de 10 meses entre marzo de 2008 y enero de 2009. Se realizaron 10 intervenciones y se cliparon 11 aneurismas, de los cuales 5 fueron diagnosticados tras su ruptura y 6 no. Se utilizaron verde de indocianina intravenosa y microscopio quirúrgico Leica OH4 con módulo de fluorescencia vascular intraoperatoria Leica FL800, con cámara infrarroja Sony (Heerbrugg-Suiza). Se recoge la información ofrecida por esta técnica durante la intervención y se compara con las imágenes de la arteriografía postoperatoria a las 24 horas. Se valoraron la oclusión total o parcial de la lesión aneurismática así como la preservación o no de la vascularización adyacente.

Resultados

Los hallazgos de la videoangiografía intraoperatoria sobre las lesiones aneurismáticas fueron de oclusión completa en todos los casos y permeabilidad de los vasos vecinos. Estos resultados se corresponden completamente con los de la arteriografía postoperatoria, excepto en un caso donde la arteriografía evidenció vasoespasmo moderado-grave sin repercusión clínica que durante la videoangiografía intraoperatoria no fue percibido. Clínicamente ningún paciente presentó déficits neurológicos añadidos.

Conclusiones

La videoangiografía intraoperatoria es una herramienta de fácil aplicación que ofrece información valiosa en cuanto a la oclusión completa del saco aneurismático y la permeabilidad de los vasos adyacentes a éste.

Palabras clave:
Videoangiografía intraoperatoria
Summary
Objective

The authors’ objective is to report the initial appreciations on the use of the intraoperative nearinfrared indocyanine green videoangiography during aneurysm surgery in our center.

Method

10 surgical procedures have been made in 9 patients, 5 males and 4 females between 27 and 61 years old with an average of age of 49 years during a time of 10 months between March, 2008 and January, 2009. 10 surgical procedures were performed and 11 aneurysms were clipped. Intravenous indocyanine green and surgical microscope Leica OH4 with module of vascular fluorescence intraoperating Leica FL800, with camera infrared Sony (Heerbrugg-Switzerland) were used. The information offered by this technique during the intervention is compared with the images of the postoperative angiography performed during the first 24 hours. The partial or complete occlusion and the respect to the near vessels were evaluated.

Results

The findings of the intraoperative videoangiography were the complete occlusion and absence of complications in all the cases. These results corresponded completely with the postoperative results of the angiography postoperative, except in a case where the angiography demonstrated vasoespasmo moderate without clinical repercussion that during the videoangiografía intraoperatoria was not perceived. Clinically no patient presented neurological added deficits.

Conclusions

The intraoperative videoangiography is a tool of easy application that offers valuable information as for the complete occlusion of the aneurysm and the permeability of the adjacent vessels.

Key words:
Intraoperative videoangiography
Intracranial aneurysm
Indocyanine green
Surgical microscope

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