Indocyanine green (ICG) video angiography has been used for several medical indications in the last decades. It allows a real time evaluation of vascular structures during the surgery 1,2,3,4,5 . Indocyanine green dye was developed for near-infrared photography by the Kodak Research Laboratories in 1955 and was already approved for clinical use in 1956. However, it was used for angiography in the 60´s and for retinal angiography in the 70´s. The principle of fluorescence imaging used in ICG is simple: illuminate the tissue of interest with light at the excitation wavelength (800 nm) while observing it at longer emission wavelengths (over 800 nm) 1,2,3,4,5 .Neurosurgery is ideal for ICG because operations are already done using microscope (and camera), and because the blood vessels located on the brain surface are exposed and thus can be seen more or less directly by visual means. Thus, ICG applied in vascular neurosurgical procedures has emerged as a valuable option to assess intraoperatively details of aneurysmal clipping 4,5,6,. Although with increasing reports of ICG application, there are still some points to be discussed. Additionally, Brazilian literature has no publication about such theme to the best of our knowledge. We report below the first Brazilian experience with application of ICG in the treatment of intracranial aneurysms 4,5,6 . AbstrActIndocyanine green (ICG) video angiography has been used for several medical indications in the last decades. It allows a real time evaluation of vascular structures during the surgery. This study describes the surgical results of a senior vascular neurosurgeon. We retrospectively searched our database for all aneurysm cases treated with the aid of intraoperative ICG from 2009 to 2014. A total of 61 aneurysms in 56 patients were surgically clipped using intraoperative ICG. Clip reposition after ICG happened in 2 patients (3.2%). Generally, highly variable clip adjustment rates of 2%-38% following ICG have been reported since the introduction of this imaging technique. The application of ICG in vascular neurosurgery is still an emerging challenge. It is an adjunctive strategy which facilitates aneurismal evaluation and treatment in experienced hands. Nevertheless, a qualified vascular neurosurgeon is still the most important component of a high quality work.Keywords: aneurysm, treatment, surgery, indocyanine green. resumo A angiografia intraoperatória com indocianina verde (ICG) já foi aplicada em diversas situações clínicas por vários anos. O ICG permite avaliação em tempo real de estruturas vasculares durante a cirurgia. Este artigo descreve os resultados cirúrgicos do autor sênior. Avaliamos retrospectivamente os casos de aneurismas intracranianos operados de 2009 a 2014. Um total de 61 aneurismas em 56 pacientes foram operados com ICG. O reposicionamento do clip ocorreu em 2 casos (3.2%). Geralmente, taxas variáveis de reposicionamento do clip têm sido descritas (2%-38%). A aplicação de ICG na neurocirurgia vascular ainda é um desafio crescente. É um artifí...
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