吲哚菁绿荧光血管造影在前循环动脉瘤手术中的应用

目的探讨吲哚菁绿（ICG）脑血管造影在颅内前循环动脉瘤手术中的作用。方法回顾性研究2007年1月至2008年4月开颅手术治疗的前循环动脉瘤患者42例，荧光显微镜下观察术野中血管，指导手术操作。术后行3DCTA或DSA检查，评估术中ICG荧光造影对开颅手术治疗颅内动脉瘤的作用。结果术中确认动脉瘤颈残留2例，载瘤动脉分支血管闭塞1例，穿通血管误夹2例，重新调整动脉瘤夹位置后，再次荧光血管造影，证实动脉瘤颈夹闭满意，术后DSA（或MRA、CTA）均证实术中ICG造影结果。结论ICG血管造影是一种术中监测颅内动脉瘤颈是否残留、载瘤动脉是否狭窄及穿通支血管是否闭塞的重要检查手段。

Application of intraoperative indocyanine green angiography for intracranial aneurysms of anterior circulation

Objective To investigate the application of indocyanine green （ICG） angiography in the surgery of intracranial aneurysm. Methods A total of 42 cases of intracranial aneurysms of anterior circulation underwent operation from January 2007 to April 2008 were retrospectively analyzed. The vessels in the surgical field were observed with the fluorescence microscope during the operation to provide guidance to the operation. Post-operative 3DCTA and DSA were performed to assess the effect of intraoperative ICG angiography for the treatment of intraeranial aneurysms. Results Of all the patients underwent aneurysm clipping, aneurysm neck residual was found in 2, occlusion of branching vessels in 1, and perforating artery clipping in 2 patients. The ICGA performed after clip replacement showed perfect residual elimination without abnormal findings. The results were proved by post-operative DSA, CTA and MRA. Conclusion ICG angiography is an important method in monitoring aneurysm residual, parent artery stenosis and perforating arteries occlusion during the surgery of intracranial aneurysm.