ICG angiography

ICG fluorescence is an advanced imaging technique used during aneurysm surgery to confirm proper blood flow and ensure the aneurysm is safely treated. It allows real-time visualization of blood vessels during surgery.

Quick Facts:

  • Used during aneurysm clipping procedures
  • Provides real-time blood flow imaging
  • Helps confirm complete aneurysm treatment
  • Enhances surgical precision and safety

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WHAT IS ICG FLUORESCENCE?

ICG (indocyanine green) fluorescence is a technique used during brain surgery to visualize blood flow in real time.

During surgery:

  • A small amount of dye is injected into the bloodstream
  • A special microscope with infrared capability is used
  • Blood vessels light up, showing how blood is flowing

This allows the surgeon to see:

  • Which vessels are open
  • Whether the aneurysm is fully clipped
  • Whether normal arteries are preserved

WHY IS ICG USED IN ANEURYSM SURGERY?

The goal of aneurysm surgery is to:

  • Completely close off the aneurysm
  • Preserve normal blood flow to the brain

ICG helps achieve this by:

  • Confirming complete occlusion of the aneurysm
  • Ensuring normal vessels remain open
  • Detecting issues immediately during surgery

👉 This reduces the risk of complications and improves surgical accuracy

WHO BENEFITS FROM ICG FLUORESCENCE?

ICG is used in patients undergoing:

  • Aneurysm clipping surgery
  • Complex vascular procedures
  • Cases where vessel anatomy is intricate or high-risk

It is particularly helpful when:

  • Multiple vessels are involved
  • The aneurysm is located near critical arteries
  • Precise clip placement is essential

HOW THE PROCESS WORKS

Step-by-Step Overview

  1. Craniotomy and Exposure
    • The aneurysm is exposed using microsurgical techniques
  2. ICG Injection
    • A small amount of dye is injected into a vein
  3. Fluorescence Imaging
    • The surgical microscope detects the dye as it flows through vessels
  4. Real-Time Assessment
    • The surgeon evaluates blood flow in arteries and the aneurysm
  5. Clip Adjustment (if needed)
    • The clip can be repositioned immediately if flow is not optimal

OUR APPROACH

We use ICG fluorescence as part of a precision-driven microsurgical strategy.

  • ICG is used to confirm safe and effective aneurysm treatment during surgery
  • It is combined with microsurgical technique and careful anatomical assessment
  • Not all aneurysms are treated the same—technique is tailored to each case
  • The goal is complete aneurysm occlusion with preservation of normal circulation

👉 Advanced tools support—but do not replace—surgical judgment and experience

WHAT TO EXPECT

Before Surgery

  • Imaging such as CT angiography or cerebral angiography
  • Discussion of treatment options (clipping vs endovascular approaches)

During Surgery

  • ICG is used after clip placement to confirm results
  • Additional imaging may be used if needed

After Surgery

  • Standard recovery after aneurysm clipping
  • Follow-up imaging to confirm long-term results

OUTCOMES & BENEFITS

Potential Benefits

  • Real-time confirmation of aneurysm closure
  • Improved safety during surgery
  • Reduced risk of leaving residual aneurysm
  • Protection of normal blood flow

ICG is an important tool that contributes to:

  • High-quality surgical outcomes
  • Lower complication rates

RISKS & CONSIDERATIONS

ICG is generally very safe, but considerations include:

  • Rare allergic reaction to dye
  • Limited penetration in very deep structures
  • Used as a complement—not a replacement—for other imaging

👉 Multiple techniques may be used together to ensure optimal results

FREQUENTLY ASKED QUESTIONS

Does ICG replace angiography?

No. It is used during surgery, while angiography may still be used before or after.

Is the dye safe?

Yes, ICG is widely used and generally very safe.

Will I notice anything from the dye?

No, patients do not feel the dye or see the fluorescence.

Does this improve outcomes?

It helps improve surgical accuracy and safety.

FOR REFERRING PHYSICIANS (Optional Expandable Section)

  • Refer patients with:
    • Intracranial aneurysm
    • Subarachnoid hemorrhage
    • Complex aneurysm anatomy
  • Imaging:
    • CTA or MRA
    • Diagnostic angiography when indicated
  • ICG is used intraoperatively to:
    • Confirm clip placement
    • Assess vessel patency

RELATED CONDITIONS / PROCEDURES

  • Brain Aneurysm
  • Subarachnoid Hemorrhage
  • Craniotomy for Aneurysm Clipping
  • Endovascular Coiling

CALL TO ACTION

👉 Request an Appointment
👉 Refer a Patient