Turkish Neurosurgery
Results of intraoperative sodium fluorescein video angiography and its repeated use in a series of brain aneurysm surgeries
Lutfi Sinasi Postalci1, Buruc Erkan1
1Healty Sience Universty; Basaksehir Cam and Sakura City Hospital, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.42655-22.1

Aim:Sodium fluorescein video angiography (NaF-V) allows real-time images to be obtained through the optical reflection of sodium fluorescein from the vessel wall after intravenous injection. It is commonly used in intracranial aneurysm surgery because it can show the clipping position and coagulation of the parent arteries, perforating arteries, and the aneurysm dome. This study discusses the properties of NaF-V in intracranial aneurysm surgery.Material and Methods:The clinical findings and imaging results during and after surgery for patients with aneurysm who underwent surgery between September 2020 and June 2022 were examined. NaF-V and micro-Doppler imaging were used to control the flow of the parent and perforating arteries and obliteration of the aneurysm dome. The dose of sodium fluorescein administered via the central venous route was 5 mg/kg.Results:Overall, 102 aneurysms were treated during 95 operations in 92 patients. NaF-V was applied at least once in all operations, twice in 17, and thrice in 3 operations. The period between repeated doses of NaF-V ranged from 4 to 50 min. The method allowed for the desired imaging of the parent and perforating arteries in all cases but failed to provide satisfactory results regarding the complete obliteration of the aneurysm dome in three cases. No NaF-V-related complications were encountered in any case.Conclusion:Sodium fluorescein is safe, with a high minimum toxic dosage, and provides benefits, even in repeated use, in the evaluation of perforating and parent arteries. NaF-V is effective when used alternatively or in combination with various methods.

Corresponding author : Lutfi Sinasi Postalci