Far lateral approach with intraoperative ultrasound Doppler identification of the vertebral artery

Accurate Characterization of the Main Trunk of the Anterior Cerebral Artery by Means of Intraoperative Sononavigation With Doppler Sonography

“…8 Furthermore, Doppler sonography has allowed for the preservation of major cerebral arteries, such as the internal cerebral artery and the vertebral artery, during resection of pituitary adenomas and skull base tumors. 1,5,6,9 Although sonography is the only real-time modality that can be used to monitor the residual tumor and arteries during surgery, the neuronavigation system is superior to sonography in terms of localization and preservation of critical arteries. For example, it is difficult to distinguish arteries with similar diameters, such as the main trunk and branches of the ACA, by Doppler sonography alone, but sononavigation can accurately display the location of arteries in the corresponding CT or MRI images.…”

“…ptimizing tumor resection while simultaneously preserving critical arteries inside or near the tumor is a challenging problem. Sonography and Doppler sonographic imaging have been used for the real-time intraoperative monitoring of anatomic structures, including the tumor and various arteries, during neurosurgical procedures [1][2][3][4][5][6] ; however, it is often difficult to interpret which color Doppler sonographic image corresponds to the respective arteries.…”