Dual-Image Videoangiography During Intracranial Microvascular Surgery

Alberto Feletti, Xiangdong Wang, Riki Tanaka, Yasuhiro Yamada, Daisuke Suyama, Tsukasa Kawase, Hirotoshi Sano, Yoko Kato

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Objective Indocyanine green videoangiography (ICG-VA) is a valuable tool to assess vessel and aneurysm patency during neurovascular surgical procedures. However, ICG-VA highlights vascular structures, which appear white over a black background. Anatomic relationships are sometimes difficult to understand at first glance. Dual-image videoangiography (DIVA) enables simultaneous visualization of light and near-infrared fluorescence images of ICG-VA. Methods The DIVA system was mounted on an OPMI Pentero Flow 800 intraoperative microscope. DIVA was used during microsurgical procedures on 5 patients who were operated for aneurysm clipping and superficial temporal artery–middle cerebral artery bypass. Results DIVA provides real-time simultaneous visualization of aneurysm and vessels and surrounding structures including brain, nerves, and surgical clips. Although visual contrast between vessels and background is higher with standard black-and-white imaging, DIVA makes it easier to understand anatomic relationships between intracranial structures. DIVA also provides better vision of the depth of field. Conclusions DIVA has the potential to become a widely used intraoperative tool to check patency of intracranial vessels. It should be considered as an adjunct to standard ICG-VA for better understanding of vascular anatomy in relation to surrounding structures and can have an impact on decision making during surgery.

Original languageEnglish
Pages (from-to)572-579
Number of pages8
JournalWorld Neurosurgery
Publication statusPublished - 01-03-2017

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


Dive into the research topics of 'Dual-Image Videoangiography During Intracranial Microvascular Surgery'. Together they form a unique fingerprint.

Cite this