gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Article

Send article

Endoscopic ICG angiography – routine tool during aneurysm surgery by technical advancements?

Endoskopische ICG-Angiographie – ist ein Routineeinsatz in der Aneurysmachirurgie durch technische Verbesserungen möglich?

Meeting Abstract

Search Medline for

  • presenting/speaker Dorothee Mielke - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Xenia Hautmann - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Vesna Malinova - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Christoph Bettag - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Bawarjan Schatlo - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland
  • Veit Rohde - Georg-August-Universität Göttingen, Neurochirurgie, Göttingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV133

doi: 10.3205/21dgnc126, urn:nbn:de:0183-21dgnc1260

Published: June 4, 2021

© 2021 Mielke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: It has been shown that endoscopic indocyanin green (ICG) angiography in aneurysm surgery provides the neurosurgeon with additional information in 50 % of the cases, if compared with microscopic ICG angiography. However, insufficient illumination of the operative field and a substantially poorer contrast than in microscopic ICG angiography hindered a more widespread use. The aim of the present investigation was to test if new software releases for image processing in combination with better light transmission improved this technique.

Methods: In six patients with unruptured aneurysms, endoscopic ICG angiography was performed after clip placement, using two imaging processing software solutions combined (I: dynamic brightening of dark areas of the endoscopic image; II: color contrast enhancement) and one software solutions alone (III: spectral color shift and color exchange). For each patient and each software/software combination, illumination of the operative field and intensity of contrast was rated by 4 neurosurgeons not involved in the treatment as poor (1 point), moderate (2 points) or good (3 points). In a second step, the neurosurgeons compared the image quality with that of video-taped endoscopic ICG angiographies that had been performed before the recent soft- and hardware release and of microscopic ICG angiographies in 3 patients each.

Results: Better results in terms of contrast were obtained with the combination of software I and II (6.5 versus 5), whereas software III scored better in terms of illumination (6.75 versus 4). If compared with the “old” endoscopic ICG angiographies, the image quality was constantly rated as being better irrespective of the applied software. If compared with microscopic ICG angiography, the image quality of endoscopic ICG angiography is as good (contrast: 6.5 versus 7.25, illumination: 6.75 versus 6) as microscopic ICG angiography.

Conclusion: Recent software releases together with improved light transmission substantially improved the quality of endoscopic ICG angiography, being now as good as microscopic ICG angiography. At latest now, endoscopic ICG angiography can considered being a useful tool during aneurysm surgery.