Revista de columna vertebral y neurocirugía

Use of ICG Videoangiography in Surgical Treatment of Spinal Dural Arterovenous Fistulas sdavf

Alessandro Landi

Introduction: It is recognized that a timely diagnosis, followed by the occlusion of the shunting zone during surgical treatment, are essential in the spinal dural arterio-venous fistulas treatment. Our purpose is to show that better results can be obtained using intraoperative Indocianine green colour video angiography pre and post clipping during the surgical procedures. Methods: interruption of abnormal arterovenous connection is the aim of the treatment of spinal dural artero-venous fistulas. In order to focus, exactly, point of fistula, we used Indocianine green video angiography intra operative during 18 surgical procedures before positioning the clip, and after that, to control the correct vascular reset. A 48 hours post operative control angiography has been performed in all patients. Clinical follow up lasted approximately 7 months. Results: Intraoperative Indocianine video angiography was used in all 18 cases and the occlusion of the DAVF at post-operative angiography was confirmed in 17 cases. One patient has been retreated because of a minimal residual fistula. No side effects due to the indocianine videoangiography have been reported. Conclusions: Use of intraoperative indocianine videoangiography represent a safe method to investigate the malformation during surgery and allow to obtain excellent results in the treatment of sDAVF.