Indocyanine Green Videoangiography in the Management of Dural Arteriovenous Fistulae

Abstract

OBJECTIVE: To evaluate the usefulness of indocyanine green (ICG) videoangiography in the operative management of dural arteriovenous fistulae (dAVFs). METHODS: Intraoperative ICG videoangiography was used as a surgical adjunct in 25 patients with cranial and spinal dural arteriovenous fistulae to identify the fistula and verify its complete obliteration. The findings on ICG videoangiography were compared with intraoperative and/or postoperative imaging. RESULTS: All dural arteriovenous fistulae were clearly identified by intraoperative ICG videoangiography and obliteration was documented in each case. Findings on ICG videoangiography correlated with intraoperative and/or postoperative imaging. CONCLUSION: ICG videoangiography is a useful adjunct to the surgical management of dural arteriovenous fistulae for localization and confirmation of complete obliteration. The safety and ease of use make it an attractive modality. The surgeon can only evaluate what is visualized under the operating microscope and must therefore fully expose the venous drainage of the fistula to confirm obliteration.