吲哚菁绿荧光血管造影在前交通动脉瘤夹闭术中的应用

目的探讨吲哚菁绿荧光血管造影在前交通动脉瘤夹闭术中的应用价值。方法回顾性分析开颅手术治疗19例前交通动脉瘤病例。术中采用吲哚菁绿荧光造影，评估动脉瘤夹闭情况以及载瘤动脉的血供情况，根据造影结果必要时调整动脉瘤夹。术后复查3D—CTA判断动脉瘤夹闭情况。结果19例前交通动脉瘤夹闭ICG荧光血管造影证实动脉瘤颈残留1例，误夹穿通血管1例，经重新调整动脉瘤夹位置后，均再次行荧光血管造影，证实动脉瘤颈夹闭满意，载瘤动脉及分支血管通畅，余17例ICG造影示夹闭满意。术后3D-CTA检查动脉瘤夹闭完全，载瘤动脉通畅，与术中ICG造影显像一致。结论术中吲哚菁绿血管造影简便易行，具有理想的空间和时间分辨率，具有可重复、安全性高等特点，对术中判断动脉瘤颈是否夹闭完全、载瘤动脉是否狭窄，远端分支是否通畅有重要参考价值，增加了手术安全性。

Application of intraoperative indocyanine green angiography during anterior communicating aneurysm clipping

Objective To investigate the effect of using indocyanine green （ICG） angiography in anterior communicating aneurysm clipping. Methods Surgical experience of 19 patients with anterior communicating aneu- rysms was analyzed retrospectively. All patients underwent ICG angiography to evaluate tile aneurysm clipping and the parent arteries. Post-operative 3D-CTA was perfom~ed to conform the complete aneurysm obliteration. Results Dur- ing the microsurgical procedure, aneurysm neck remnant was found in 1 patient and perforating artery clipping in 1 patient. The ICG angiography performed after clip replacement showed that the aneurysm was completely obliterated and the parent artery and perforating artery were patent. The intraoperative angiography findings completely correspon- ded to the postoperative 3D-CTA. Conclusion The high spatial and temporal resolution of the images, the simplicity and repeatability of the ICG angiography could be used to judge whether the aneurysm is completely obliterated, the parent and distal artery is stenosis, perforating arteries occlusion, and can improve the safety of the operatiom