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Intraoperative Indocyanine Green Video-Angiography: Spinal Dural Arteriovenous Fistula

Oh, Jae Keun, MD*; Shin, Hyun Chul, MD; Kim, Tae Yup, MD*; Choi, Gwi Hyun, MD*; Ji, Gyu Yeul, MD*; Yi, Seong, MD, PhD*; Ha, Yoon, MD, PhD*; Kim, Keung Nyun, MD, PhD*; Yoon, Do Heum, MD, PhD*

doi: 10.1097/BRS.0b013e318213c41e
Technical Note
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Study Design. Technical note.

Objective. To describe the use of intraoperative indocyanine green (ICG) video-angiography for obliteration of a spinal dural arteriovenous fistula (DAVF) and to show a video clip.

Summary of Background Data. ICG video-angiography is an emerging tool for delineating intraoperative vascular anatomy, and it has a significant potential in the treatment of vascular diseases in the spine.

Methods. The authors presented a case of a 73-year-old man with progressive and debilitating bilateral lower extremity weakness. The patient was diagnosed with a spinal DAVF of 10th thoracic spine based on the results of conventional spinal angiography.

Results. The patient underwent T9–10 laminotomy for microsurgical clip occlusion. Intraoperative ICG video-angiography was used before clip placement to identify the arterialized veins of the fistula and after clip placement to confirm obliteration of the fistulous connection and restoration of normal blood flow.

Conclusion. Intraoperative ICG video-angiography serves an important role in the microsurgical treatment of DAVF. It is simple and provides real-time information about the precise location of spinal DAVF and result after obliteration of spinal DAVF.

Intraoperative indocyanine green video-angiography serves an important role in the microsurgical treatment of dural arteriovenous fistula. It is simple and provides real-time information about the precise location of spinal dural arteriovenous fistula and result after obliteration of spinal dural arteriovenous fistula.

*Department of Neurosurgery, Spine and Spinal Cord Research Institute, College of Medicine, Yonsei University, Seoul, Korea

Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea.

Address correspondence and reprint requests to Seong Yi, MD, PhD, Department of Neurosurgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120–752, Korea; E-mail: yiseong@yuhs.ac

Acknowledgment date: October 11, 2010. Revised date: December 28, 2010. Accepted date: January 10, 2011.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Foundation and federal funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by the 2009 National Agenda Project funded by the Korea Research Council of Fundamental Science & Technology (P-09-JC-LU63-C01).

© 2011 Lippincott Williams & Wilkins, Inc.