PMC6917574_01
PMC6917574_02
PMC6917574_03
PMC6917574_04
PMC6917574_05
A large right temporoparietal AVM is exposed (A). ICG videoangiography (B) demonstrates the early filling of the arterial feeders (red arrow) and delayed filling of arterialized veins (purple arrow); this technique can confirm the identity of these vessels more accurately especially if they are covered by thick arachnoid bands. This information can also guide the early steps of disconnection to start in the area where the concentration of feeding arteries is most (red arrow). The same AVM was analyzed via the use of FLOW 800 software. Please note the feeding arteries in red, arterialized veins in yellow, and normal veins in blue (C). Post-resection FLOW 800 analysis demonstrates that the primary vein is now blue (D).
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F1
The senior author recently published his experience using ICG VA in a small group of patients who were undergoing cerebrovascular neurosurgery (Figure 1).
Fluorescein videoangioram of a parietal AVM demonstrates the relative flow in different components of the AVM: feeding artery (red arrow), arterialized vein (purple arrow), and normal vein (blue arrow).
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F2
The advantage of fluorescein over ICG is that the dye can be visualized through the microscope's binoculars (Figure 2).