Study on the causes of "false ⁃ negative" in indocyanine green angiography during intracranial aneurysm surgery

Abstract

Objective To explore the causes and treatment principles of the "false ⁃ negative" phenomenon of intraoperative near ⁃ infrared indocyanine green angiography (ICGA) during intracranial aneurysm surgery. Methods The causes of "false ⁃ negative" and limitations of ICGA during aneurysm surgery were analysed and the related treatment principles were studied. Results Seven patients with intracranial aneurysm presented ICGA "false⁃negative" during surgical clipping. When the aneurysm body was incised or stabbed errhysis may emerged. After immediately cleaned away the oozing of blood at the neck of aneurysm and regulated the clipping position of aneurysm, errhysis was eliminated. Conclusion Although ICGA is useful in determining the obliteration of aneurysm by surgical clipping, there are some limitations. Wide ⁃ necked aneurysm, thrombosis on the neck of aneurysm or atheromatous plaque at the vessel wall and arachnoid incomplete seperated may induce ICGA "false⁃negative". Therefore, when ICGA "false negative" occurs in surgical clipping of aneurysm other monitoring methods should be used to confirm the obliteration of aneurysm. DOI：10.3969/j.issn.1672⁃6731.2012.01.005

Keywords

• Intracranial aneurysm
• Fluorescein angiography
• Indocyanine green