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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(03): 556-563
DOI: 10.1055/s-0045-1809049
Original Article

A Comparative Analysis between Intraoperative Fluorescein Sodium Videoangiography and Postoperative Imaging for Evaluating Clipped Intracranial Aneurysms

Marcos Dellaretti 
1   Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
2   Department of Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
André Guimarães Soares
1   Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
,
Allan Douglas Oliveira Lima 
1   Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
,
Matheus Tavares Melo 
1   Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
,
Natalia Dilella Acherman 
2   Department of Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
Júlio Cesar Almeida 
1   Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
,
Vitor Deus Rocha Ribeiro Gonçalves 
1   Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
,
Bruno Silva Costa 
1   Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
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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.

Keywords

sodium fluorescein - intracranial aneurysms - microsurgery


Publikationsverlauf

Artikel online veröffentlicht:
26. Mai 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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