Intraoperative indocyanine green videoangiography for identification of XXXX using a microscopic transsphenoidal approach.

@entity1 @entity227 @entity1313 @entity3194 @entity4611 @entity2012 @entity977 @entity1296 @entity652
PURPOSE: Initial successful surgical treatment of @entity977 is crucial to reach long-term remission. @entity3194  (ICG) videoangiography (VA) is well established in vascular neurosurgery nowadays and several reports described ICG application in @entity1313 surgery. We designed this study to evaluate the feasibility of intravenous application of ICG and visualisation of a @entity4611 via the fluorescence mode of the operation microscope. METHODS: 22 @entity1 with @entity977 were treated with transsphenoidal microsurgery and were included in this study. Intraoperatively 25  mg ICG was administered intravenously and visualized via the fluorescence mode of the operation microscope (Pentero/Zeiss). RESULTS: 22 @entity1 qualified for transsphenoidal surgery presenting with different clinical symptoms (13 @entity1 with @entity2012 , 6 with M. Cushing and 3 with other symptoms like @entity227 or @entity1296 ) and identification of a @entity4611 (21 of 22 @entity1 ) in preoperative MR-imaging (mean diameter: 9  mm; SD 3.6; 6 macroadenomas, 15 microadenomas, 1 MR-negative). In all 22 @entity1 ICG  VA was performed during surgery. No technical failures or adverse events after drug administration occurred. Visualization was optimal approximately 2.4  min after intravenous application. In all @entity1 the @entity652 could be detected via two different types of visualization: direct visualization by fluorophore emission versus indirect detection of the @entity652 by a lower ICG  fluorescence compared to the surrounding tissue. CONCLUSION: Our data show that intraoperative ICG VA  can be a useful and easily applicable additional diagnostic tool for visualization of pituitary lesions using the microscopic approach.
