Comparison of Intraoperative Indocyanine Green Videoangiography vs Postoperative Catheter Angiography to Confirm Microsurgical Occlusion of Spinal Dorsal Intradural Arteriovenous Fistulas
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作者:
Karahalios, Katherine
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St Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USASt Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USA
Karahalios, Katherine
[1
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Srinivasan, Visish M.
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St Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USASt Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USA
Srinivasan, Visish M.
[1
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Scherschinski, Lea
[1
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DiDomenico, Joseph D.
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St Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USASt Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USA
DiDomenico, Joseph D.
[1
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Catapano, Joshua S.
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St Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USASt Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USA
Catapano, Joshua S.
[1
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Safaee, Michael M.
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Univ Calif San Francisco, Dept Neurosurg, San Francisco, CA USASt Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USA
Safaee, Michael M.
[2
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Lawton, Michael T.
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St Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USASt Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USA
Lawton, Michael T.
[1
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机构:
[1] St Josephs Hosp, Dept Neurosurg, Barrow Neurol Inst, Phoenix, AZ 85013 USA
[2] Univ Calif San Francisco, Dept Neurosurg, San Francisco, CA USA
Arteriovenous fistula;
Digital subtraction angiography;
Dorsal intradural arteriovenous fistula;
Indocyanine green videoangiography;
Type 1 arteriovenous fistula;
SURGICAL-TREATMENT;
CLASSIFICATION;
MALFORMATIONS;
D O I:
10.1227/ons.0000000000000302
中图分类号:
R74 [神经病学与精神病学];
学科分类号:
摘要:
BACKGROUND: Dorsal intradural arteriovenous fistulas (DI-AVFs) represent 80% of spinal AVFs. Microsurgical clip occlusion is a durable treatment that uses preoperative and postoperative digital subtraction angiography (DSA) as standard practice. Intraoperative indocyanine green videoangiography (ICG-VA) is a valuable intraoperative adjunct in these cases. Intraoperative ICG-VA findings have not been compared with postoperative DSA findings. OBJECTIVE: To assess the diagnostic value of intraoperative ICG-VA vs postoperative DSA for spinal DI-AVFs. METHODS: A multi-institutional database of vascular malformations was queried for all surgically managed cases of DI-AVF. Patients with both intraoperative ICG-VA and postoperative DSA were included. Demographic and radiologic data, intraoperative findings, and surgical outcomes data were retrospectively analyzed. RESULTS: Forty-five patients with DI-AVF were identified (male sex, 32; mean age, 61.9 [range, 26-85] years). All DI-AVFs were treated with interruption of the fistula with clip occlusion of the draining vein. Intraoperative ICG-VA showed complete obliteration in all patients. Postoperative DSA was performed for 40 patients and confirmed complete obliteration in all patients. The negative predictive value of ICG-VA confirming complete occlusion of the DI-AVFs was 100%. Eighteen patients (47%) experienced clinical improvement, and 16 (42%) experienced no change in condition. CONCLUSION: ICG-VA is useful for intraoperative identification of DI-AVFs and confirmation of complete microsurgical occlusion. Correlation between intraoperative ICG-VA and postoperative DSA findings demonstrates the diagnostic power of ICG-VA. This finding suggests that postoperative DSA is unnecessary when intraoperative ICG-VA confirms complete occlusion of the DI-AVF, which will spare patients the procedural risk and cost of this invasive procedure.
机构:
Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
Sun, Liyong
Ren, Jian
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Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
Ren, Jian
Wang, Long
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Capital Med Univ, SanBo Brain Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
Wang, Long
Li, Jingwei
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Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
Li, Jingwei
He, Chuan
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Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
He, Chuan
Ye, Ming
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Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
Ye, Ming
Li, Guilin
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Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
Li, Guilin
Zhang, Hongqi
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Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
机构:
St Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USASt Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USA
Killory, Brendan D.
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Nakaji, Peter
Maughan, Peter H.
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St Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USASt Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USA
Maughan, Peter H.
Wait, Scott D.
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St Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USASt Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USA
Wait, Scott D.
Spetzler, Robert F.
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St Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USASt Josephs Hosp, Barrow Neurol Inst, Div Neurol Surg, Phoenix, AZ 85013 USA