A Comparative Analysis between Intraoperative Fluorescein Sodium Videoangiography and Postoperative Imaging for Evaluating Clipped Intracranial Aneurysms.
Marcos Dellaretti, André Guimarães Soares, Allan Douglas Oliveira Lima, Matheus Tavares Melo, Natalia Dilella Acherman, Júlio Cesar Almeida, Vitor Deus Rocha Ribeiro Gonçalves, Bruno Silva Costa
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Abstract
Introduction: The evaluation of clipped intracranial aneurysms postoperatively is crucial for successful surgical treatment and minimizing risks such as residual aneurysms and complications. Fluorescein sodium videoangiography (FL-VA) has been introduced to aid in this assessment, but comparative studies with postoperative imaging remain limited.
Materials and methods: A prospective observational study was conducted on 57 patients with 64 intracranial aneurysms who underwent surgery between December 2021 and September 2022. FL-VA was performed, followed by postoperative computed tomography angiography (CTA). Discordance between FL-VA and CTA findings was analyzed statistically.
Results: FL-VA showed complete occlusion in 57 out of 61 aneurysms (93.4%), with 10 cases of discordance identified in postoperative CTA. One patient showed a neck remnant in FL-VA, but CTA revealed a residual aneurysm. Another patient displayed neck remnant and stenosis in branching vessels on CTA, not identified by FL-VA. Additionally, five aneurysms had neck remnants, and three had stenosis in branching vessels, detected in CTA but missed in FL-VA. Statistical analysis did not reveal significant associations between discordance and studied factors.
Conclusion: FL-VA shows potential as an effective intraoperative assessment tool for clipped intracranial aneurysms, although further research is needed to establish its definitive efficacy and reliability compared with other modalities.
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