https://www.selleckchem.com/products/Cryptotanshinone.html BACKGROUND Native vessel patency and residual lesion are primary sources of morbidity in Cerebrovascular Surgery (CVS) requiring real-time visualization to inform surgical judgement, as is available in endovascular procedures. Micro Doppler and Indocyanine Green Fluorescence-microscopy (ICG-M) are promising evolutions over Intraoperative Angiography (IA), while digital subtraction angiography (DSA) remains gold standard. Exoscopic visualization in CVS is emerging; however, feasibility of exoscopic-based ICG (ICG-E) for CVS has not yet been reported. OBJECTIVE Provide initial experience with ICG-E video angiography in CVS. METHODS Retrospective study where two ICG-E form-factors (exoscopic-couple or self-contained handheld imager) were used to determine native vessel patency and residual and compared to DSA. RESULTS 11 patients (8 aneurysms, 3 arteriovenous malformations (AVMs)) were included. ICG-E was feasible in all, providing real-time information leading to operative decisions impacting surgical judgement. For aneurysms, discordance of IA with ICG-E and DSA was 12%. In one case, IA showed non-flow restrictive branch stenosis; however, both ICG and DSA showed patency. All AVM cases were fully obliterated, with 100% concordance between all modalities. ICG averaged 4.2 mg "dose/run" (1-4 doses/case); 1.25mg being the lowest dose allowing visualization with no advantage with escalating dosages. There were no intra/perioperative complications. CONCLUSION In this preliminary study, ICG-E was safe and feasible, providing real-time visualization informing surgical decision-making. The last 4 cases (2 aneurysms and 2 AVMs) evolved towards a portable handheld device-a readily accessible real-time modality providing contextual anatomic and flow visualization. Larger studies will be needed to assess broader safety, dose escalation, and efficacy. The maternal protein diet during the perinatal period can program the h