Indocyanine green videoangiography (ICGV)-guided surgery of parasagittal meningiomas occluding the superior sagittal sinus (SSS)

• DOI: 10.1007/s00701-012-1617-5
• Publication Date: 2013-01-09T17:24:50Z
• Authors: Elena d’Avella; Francesco Volpin; Renzo Manara; Renato Scienza; Alessandro Della ...
• Keywords: Adult; Indocyanine Green; Male; Microsurgery; Indocyanine green videoangiography (ICGV)-guided surgery of parasagittal meningiomas occluding the superior sagittal sinus (SSS).; 03 medical and health sciences; 0302 clinical medicine; Image Interpretation, Computer-Assisted; Meningeal Neoplasms; Indocyanine green videoangiography; Parasagittal meningioma surgery; Superior sagittal sinus; Venous system; Adult; Aged; Angiography, Digital Subtraction; Cerebral Angiography; Craniotomy; Female; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Magnetic Resonance Angiography; Male; Meningeal Neoplasms; Meningioma; Microsurgery; Middle Aged; Neuronavigation; Prospective Studies; Superior Sagittal Sinus; Tomography, X-Ray Computed; Video-Assisted Surgery; Indocyanine Green; Surgery; Neurology (clinical); Humans; Prospective Studies; Neuronavigation; Aged; Angiography, Digital Subtraction; Middle Aged; Image Enhancement; Cerebral Angiography; Female; Meningioma; Superior Sagittal Sinus; Tomography, X-Ray Computed; Craniotomy; Magnetic Resonance Angiography

Maximal safe resection is the goal of correct surgical treatment of parasagittal meningiomas, and it is intimately related to the venous anatomy both near and directly involved by the tumor. Indocyanine green videoangiography (ICGV) has already been advocated as an intra-operative resourceful technique in brain tumor surgery for the identification of vessels. The aim of this study was to investigate the role of ICGV in surgery of parasagittal meningiomas occluding the superior sagittal sinus (SSS).In this study, we prospectively analyzed clinical, radiological and intra-operative findings of patients affected by parasagittal meningioma occluding the SSS, who underwent ICGV assisted-surgery. Radiological diagnosis of complete SSS occlusion was pre-operatively established in all cases. ICGV was performed before dural opening, before and during tumor resection, at the end of the procedure.Five patients were included in our study. In all cases, ICGV guided dural opening, tumor resection, and venous management. The venous collateral pathway was easily identified and preserved in all cases. Radical resection was achieved in four cases. Surgery was uneventful in all cases.Despite the small number of patients, our study shows that ICG videoangiography could play a crucial role in guiding surgery of parasagittal meningioma occluding the SSS. Further studies are needed to define the role of this technique on functional and oncological outcome of these patients.