Intraoperative Indocyanine Green Videoangiography with FLOW800 and Multimodal Fusion Neuro-Navigation for the Resection of Arteriovenous Malformation with Reduced Blood Loss.

[OBJECTIVE] To assess the safety and effectiveness of combining indocyanine green videoangiography with FLOW800 and multimodal fusion neuro-navigation in brain arteriovenous malformation (AVM) microsurgical resection.

[METHODS] From January 1, 2019 to December 31, 2022, 90 consecutive patients at The First Affiliated Hospital of Soochow University diagnosed with AVMs were included. Patients were divided into a combined treatment group and a noncombined treatment group based on the treatment received. Clinical data including baseline characteristics, image findings, modified Rankin Score, and preoperation and postoperation hemoglobin (Hb)/hematocrit (HCT) levels were reviewed and collected for statistical analysis.

[RESULTS] Compared with the noncombined treatment group, the combined treatment group demonstrated a smaller postoperative decline in Hb and HCT levels after operation and a higher proportion of patients with no disability at discharge and at the 6-month follow-up. Additionally, the combined treatment group had lower rates of reoperation and postoperative complications. Compared with the noncombined treatment group, the combined treatment group demonstrated a smaller postoperative decline in Hb and HCT levels and a higher proportion of patients with no disability at discharge and at the 6-month follow-up. Additionally, the combined treatment group had lower rates of reoperation and postoperative complications.

[CONCLUSIONS] The combined utilization of intraoperative indocyanine green videoangiography with FLOW800 and multimodal fusion neuro-navigation appears to reduce intraoperative blood loss and enhance functional outcomes in AVM microsurgery, thereby improving both the safety and efficacy of the procedure.