Universal fluorescence module for intraoperative fluorescein angiography-a technical report.

Area of Science:

• Neurosurgery
• Medical Devices
• Biomedical Engineering

Background:

• Suboptimal cerebral aneurysm clipping rates can reach 12% even in specialized centers.
• Current intraoperative fluorescence angiography methods (ICG, fluorescein sodium) are effective but costly.
• High costs limit the widespread adoption of advanced intraoperative flow assessment techniques.

Purpose of the Study:

• To describe a newly developed low-cost universal fluorescence module (FM) for intraoperative angiography.
• To present the initial clinical experience using the FM in cerebral aneurysm treatment.
• To evaluate the FM's efficacy in visualizing vascular structures during surgery.

Main Methods:

• A universal fluorescence module (FM) was designed using specific excitation and barrier filters (460-490 nm and >520 nm).
• The FM utilized a 3D-printed tray and repurposed microscope drape fittings for sterile, adaptable attachment.
• Four patients underwent cerebral aneurysm clipping with the FM between April and September 2018.

Main Results:

• The FM successfully produced bright green fluorescence against a dark background after fluorescein sodium injection.
• Blood vessels were clearly delineated from non-contrast-filled structures, including clipped aneurysms.
• Vascular anatomy, including perforating arteries, was visualized without distortion.

Conclusions:

• The developed universal fluorescence module (FM) enables successful intraoperative fluorescence angiography.
• This simple, low-cost device offers a viable alternative for intraoperative flow assessment.
• The FM is particularly beneficial for resource-limited centers lacking advanced angiography equipment.