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Journals / Medical Records / 2026 / Sayı: 1

Safety and Efficacy of Intraoperative Indocyanine Green and Sodium Fluorescein Use in AVM Surgery

Avm Cerrahisinde İntraoperatif İndosiyanin Yeşili ve Sodyum Floresein Kullaniminin Güvenilirliği ve Etkinliği

Utku Özgen(Amerikan Hastanesi)0000-0001-8381-0700
Talat Kırış(Amerikan Hastanesi)0000-0002-0938-5221
Pages
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Publication Date
2026-03-24
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Given their complementary advantages and limitations, the combined use of these videoangiography techniques in AVM surgery offers a more comprehensive, reliable, and effective intraoperative assessment.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: In our study, authors retrospectively analyzed the outcomes of 14 patients who underwent surgery using microsurgical techniques with the aid of intraoperative Na-Fl and ICG angiography.
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Key Findings & Data:Material and Methods: Authors retrospectively evaluate the outcomes of 14 AVM patients who underwent surgery with the aid of Na-Fl (Akorn, Inc.) at American Hospital (Istanbul, Türkiye) and Liv Hospital (Istanbul, Türkiye) and to demonstrate the benefits provided by the use of Na-Fl (Akorn, Inc.) and ICG (Verdye, Diagnostic Green GmbH, Aschheim, Germany) during surgery.
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Conclusion & Impact:Conclusion: Given their complementary advantages and limitations, the combined use of these videoangiography techniques in AVM surgery offers a more comprehensive, reliable, and effective intraoperative assessment.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:sodyum floresein anjiografi · indosiyanin yeşili anjiografi · mikrocerrahi

Abstract

Aim: In our study, authors retrospectively analyzed the outcomes of 14 patients who underwent surgery using microsurgical techniques with the aid of intraoperative Na-Fl and ICG angiography. Our aim was to highlight the importance and advantages of using Na-Fl and ICG during AVM surgery. Material and Methods: Authors retrospectively evaluate the outcomes of 14 AVM patients who underwent surgery with the aid of Na-Fl (Akorn, Inc.) at American Hospital (Istanbul, Türkiye) and Liv Hospital (Istanbul, Türkiye) and to demonstrate the benefits provided by the use of Na-Fl (Akorn, Inc.) and ICG (Verdye, Diagnostic Green GmbH, Aschheim, Germany) during surgery. All patients underwent preoperative cerebral angiography, and their AVMs were graded according to the Spetzler-Martin classification except one patient with spinal AVM. Angioarchitecture of AVMs were identified using the Yellow 560 filter of the Kinevo 900 surgical microscope (Carl Zeiss Meditec, Oberkochen, Germany) and ICG angiography with INFRARED 800 filter. In all patients, early postoperative control digital subtraction angiography (DSA) was performed. Results: Eight (57.15%) of the patients were male and six (42.85%) were female. The mean age of the patients was 57.26 ± 21.38 years. According to the Spetzler-Martin classification, 5 patients had Grade I AVMs, 3 had Grade II, and 5 had Grade III AVMs. One patient had a glomus type cervical intramedullary AVM. Hemorrhagic AVMs were present in six (42.85%) patients, while eight (57.15%) patients had non-hemorrhagic AVMs. None of the patients required reoperation for residual AVM. Importantly, no adverse reactions or complications related to Na-Fl or ICG administration were observed in any patient, demonstrating the safety profile of these fluorescent agents at the administered doses. Conclusion: Given their complementary advantages and limitations, the combined use of these videoangiography techniques in AVM surgery offers a more comprehensive, reliable, and effective intraoperative assessment.

Özet

Amaç: Çalışmamızda, yazarlar intraoperatif sodyum floresein ve indosiyanin yeşili (ICG) anjiyografisi yardımıyla mikrocerrahi teknikler kullanılarak ameliyat edilen 14 hastanın sonuçlarını retrospektif olarak analiz etmiştir. Amacımız, AVM cerrahisinde sodyum floresein ve ICG kullanımının önemini ve avantajlarını vurgulamaktır. Gereç ve Yöntemler: Yazarlar, sodyum floresein (Na-Fl, Akorn, Inc.) yardımıyla xxxxx ve xxxxx’te ameliyat edilen 14 AVM hastasının sonuçlarını retrospektif olarak değerlendirmiş ve ameliyat sırasında sodyum floresein ve indosiyanin yeşili (ICG) kullanımının sağladığı faydaları göstermeyi amaçlamıştır. Tüm hastalara preoperatif serebral anjiyografi yapılmış, AVM’ler Spetzler-Martin sınıflamasına göre derecelendirilmiştir (bir spinal AVM hastası hariç). AVM'lerin anjiyoarkitektürleri, Kinevo 900 cerrahi mikroskobun (Carl Zeiss Meditec, Oberkochen, Almanya) Yellow 560 filtresi ve ICG anjiyografi için INFRARED 800 filtresi kullanılarak değerlendirilmiştir. Tüm hastalara ameliyat sonrası erken dönemde kontrol dijital substraksiyon anjiyografisi (DSA) yapılmıştır. Bulgular: Hastaların sekizi (%57,15) erkek, altısı (%42,85) kadındı. Hastaların ortalama yaşı 57,26 ± 21,38 idi. Spetzler-Martin sınıflamasına göre 5 hastada Grade I, 3 hastada Grade II ve 5 hastada Grade III AVM mevcuttu. Bir hastada glomus tipi servikal intramedüller AVM vardı. Altı (%42,85) hastada hemorajik, sekiz (%57,15) hastada ise non-hemorajik AVM mevcuttu. Hiçbir hastada rezidüel AVM nedeniyle yeniden ameliyat gereksinimi olmadı. Önemli olarak, hiçbir hastada Na-Fl veya ICG uygulamasına bağlı advers reaksiyon veya komplikasyon gözlenmemiş, bu da uygulanan dozlarda bu floresan ajanların güvenlik profilini göstermiştir. Sonuç: Bu videoanjiyografi tekniklerinin birbirini tamamlayan avantaj ve sınırlamaları göz önünde bulundurulduğunda, AVM cerrahisinde bu yöntemlerin birlikte kullanımı daha kapsamlı, güvenilir ve etkili bir intraoperatif değerlendirme sunmaktadır.

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Cite This Article

Özgen, U., Kırış, T. (2026). Safety and Efficacy of Intraoperative Indocyanine Green and Sodium Fluorescein Use in AVM Surgery. Medical Records, Sayı: 1. https://doi.org/10.37990/medr.1873203

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