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Updated: Jun 6, 2026
Characterization of Vascular Morphology of Neovascular Age-Related Macular Degeneration by Indocyanine Green Angiography
Published on: August 11, 2023
Indocyanin green videoangiography study of hemangioblastomas
Yasuo Murai1, Koji Adachi, Fumihiro Matano
1Department of Neurosurgery, Nippon Medical School, Tokyo, Japan.
Insights
Intraoperative indocyanin green videoangiography (ICGVAG) aids in the safe resection of cerebellar hemangioblastoma (HB). This technique effectively differentiates feeding and draining vessels and confirms complete tumor removal, improving surgical outcomes.
Area of Science:
- Neurosurgery
- Surgical Oncology
- Medical Imaging
Background:
- Cerebellar hemangioblastomas (HB) present diagnostic challenges.
- Accurate surgical planning is crucial for effective HB resection.
- Intraoperative visualization of tumor vasculature is essential.
Observation:
- Three cases of cerebellar hemangioblastoma (HB) underwent surgery.
- Indocyanin green videoangiography (ICGVAG) was utilized intraoperatively.
- No preoperative embolization or prior interventions affecting ICG findings were performed.
Findings:
- ICGVAG allowed for precise identification of feeding and draining vessels.
- The technique confirmed the complete elimination of the mural nodule.
- Postoperative MRI confirmed no residual tumor and no ischemic changes.
Implications:
- ICGVAG is a valuable tool for safe and effective cerebellar hemangioblastoma resection.
- The method enhances surgical precision by clarifying tumor vascularity.
- This technique contributes to improved patient outcomes by ensuring complete tumor removal.
Objective:
We present herein the intraoperative indocyanin green videoangiography (ICGVAG) findings for three cases of cerebellar hemangioblastoma (HB).
Cases:
Cerebellar HB was detected in three patients presenting with symptoms of vertigo and/or headaches and diagnosed on the basis of preoperative magnetic resonance imaging (MRI) and cerebral angiographic findings. Preoperative embolization of the tumor feeding artery was not performed in any of the patients. None of the patients underwent any procedure prior to ICGVAG that would affect the ICG findings, such as perilesional hemostatic coagulation or ablation. In each patient, it was possible to judge the approximate location of the tumor in relation to the brain surface and to distinguish the feeding and draining vessels. Following resection of the tumor, ICGVAG images confirmed that the mural nodule had been eliminated. None of the patients required blood transfusion, either during or after the surgery. For each patient, the lesion was pathologically confirmed as HB, postoperative contrast-enhanced MRI confirmed the absence of residual tumor, and diffusion-weighted MRI revealed no ischemic changes.
Results:
Differentiation of feeding and draining vessels in the region of the lesion is particularly important for successful surgical removal of HB. In the present three patients, ICGVAG findings enabled easy vascular differentiation and were also useful for confirming that there was no residual tumor. Indocyanin green videoangiography was concluded to be useful for safe resection of HB.
