Utilizing indocyanine green video angiography to bridge intracranial aneurysm treatment gaps in low- and middle-income countries: a mini-review

Ghosh, Shankhaneel, Awuah, Wireko Andrew, Bharadwaj, Hareesha Rishab, Adebusoye, Favour Tope, Ou Yong, Brian M., Wellington, Jack, Abdul-Rahman, Toufik and Ovechkin, Denys 2023. Utilizing indocyanine green video angiography to bridge intracranial aneurysm treatment gaps in low- and middle-income countries: a mini-review. Journal of International Medical Research 51 (10) 10.1177/03000605231204427

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Abstract

Intracranial aneurysms, affecting 2%–5% of the population, pose a significant challenge to neurosurgeons due to their potential to cause subarachnoid haemorrhage and high mortality rates. Intraoperative angiography is necessary for effective surgical planning and indocyanine green video angiography (ICG-VA) has emerged as a useful tool for real-time visualization of aneurysmal blood flow, aiding in better planning for potential blood flow and detection of aneurysm remnants. This mini narrative review explores the application of ICG-VA in intracranial aneurysm surgery. Compared with conventional dye-based angiography, ICG-VA is safer, more effective and more cost-effective. It can assess haemodynamic parameters, cerebral flow during temporary artery occlusion, completeness of clipping and patency of branch vessels. However, implementing ICG-VA in low- and middle-income countries presents challenges such as financial constraints, limited access to training and expertise, patient selection and consent issues. Addressing these obstacles requires capacity-building, training programmes for neurosurgeons and multidisciplinary teams, technology transfer, equipment donations, public–private partnerships, continued research and development, reducing conventional dye usage, reducing ICG wastage, exploring mechanisms to reuse ICG dyes and advocating for increased government funding and healthcare budgets.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: https://creativecommons.org/licenses/by-nc/4.0/, Start Date: 2023-10-20
Publisher:	SAGE Publications
ISSN:	0300-0605
Date of First Compliant Deposit:	23 October 2023
Date of Acceptance:	13 September 2023
Last Modified:	10 Feb 2024 02:21
URI:	https://orca.cardiff.ac.uk/id/eprint/163427

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