SURGICAL VIDEO Microarteriovenous Malformations—Value of Indocyanine Green Fluorescence and Nuances of Surgical Excision: 2-Dimensional Operative Video Thomas J. Sorenson, BS, Lucas Carlstrom, MD, PhD, Giuseppe Lanzino, MD Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota Watch now at https://academic.oup.com/ons/article-lookup/doi/10.1093/ons/opy102 Correspondence: Giuseppe Lanzino, MD, Department of Radiology and Neurologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55902. E-mail: Lanzino.Giuseppe@mayo.edu MicroAVMs (microarteriovenous malformation) are arteri- during surgical exploration. Advances in frameless stereo- ovenous shunts with a nidus smaller than 1 centimeter. tactic neuronavigation and the introduction of intraoper- They are typically diagnosed after hemorrhage. When the ative indocyanine green (ICG) fluorescein provide useful nidus is very small, diagnosis can be challenging even adjuncts in the surgical treatment of these relatively on catheter angiography and careful examination of the uncommon lesions. In this video, we present 2 cases which arterial and capillary phases is required to identify the early document the value of intraoperative ICG fluorescein as shunt. Because of the very small size, identification and well as some of the surgical pitfalls in the treatment of localization of the actual AV shunt can be problematic these lesions. KEY WORDS: Microarteriovenous malformation, AVM, Microsurgery, Endovascular, ICG fluorescein, Neuronavigation Operative Neurosurgery 0:1, 2018 DOI:10.1093/ons/opy102 Received, January 4, 2018. Accepted, April 4, 2018. Disclosure REFERENCE The authors have no personal, financial, or institutional interest in any of the 1. Alén JF, Lagares A, Paredes I, et al. Cerebral microarteriovenous malformations: a drugs, materials, or devices described in this article. series of 28 cases. JNeurosurg. 2013;119(3):594-602. OPERATIVE NEUROSURGERY VOLUME 0 | NUMBER 0 | 2018 | 1 Downloaded from https://academic.oup.com/ons/advance-article-abstract/doi/10.1093/ons/opy102/4989156 by Ed 'DeepDyve' Gillespie user on 12 July 2018
Operative Neurosurgery – Oxford University Press
Published: Apr 27, 2018
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