Intraoperative Assessment Using Indocyanine Green Versus Sodium Fluorescein in Aneurysm Clipping: Review of Cases and Literature

Abstract

Introduction: The fundamental challenge of aneurysm clipping is to secure a complete neck occlusion while preserving both parent and their subsequent branch arteries along with the surrounding perforators. Indocyanine Green Video angiography (ICG-VA) and Fluorescein Sodium Angiography (FNa-VA) are microscope-integrated fluorescence that offer a more affordable intraoperative evaluation of the cerebral vasculature. We present our experience in using intraoperative ICG-VA and FNa-VA in aneurysm clipping cases along with the literature review to compare both fluorescence techniques. Case Series: Two patients with subarachnoid arachnoid hemorrhage caused by a ruptured aneurysm were involved, and surgical clipping of the aneurysm was done. Intraoperative assessment of cerebral vasculature was performed using both ICG-VA and FL-VA. Conclusion: Both ICG-VA and FL-VA each have their own advantages and disadvantages and are safe and effective in routine use for intraoperative evaluation in aneurysm clipping surgery.