Intraoperative tools for cerebral bypass surgery

Esposito, Giuseppe; Regli, Luca

doi:10.1007/s00701-017-3455-y

Cited by 15 publications

(6 citation statements)

References 25 publications

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“…For the case of internal carotid artery occlusion with CBF deficiency preoperatively indicated by IMP‐SPECT, an intensity analysis of clinical cases was performed using the same FLOW 800 system as in this study. The intensity ratio of the brain surface sufficiently distant from the cortical vessels to the cortical artery was approximately 15% to 30% . Prinz et al also reported results similar to ours regarding the intensity comparison between the cortical artery and the brain surface in the case of the CBF deficiency.…”

Section: Discussionsupporting

confidence: 85%

Optical effects on the surrounding structure during quantitative analysis using indocyanine green videoangiography: A phantom vessel study

Tsukiyama

Murai

Matano

et al. 2018

Journal of Biophotonics

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Various reports have been published regarding quantitative evaluations of intraoperative fluorescent intensity studies using indocyanine green (ICG) with videoangiography (VAG). The effects of scattering and point-spread functions (PSF) on quantitative ICG-VAG evaluations have not been investigated. Clinically, when ICG is administered through the peripheral vein, it reaches the tissue intra-arterially. To achieve more reliable intraoperative quantitative intensity evaluations, we examined the impact of high-intensity structures on close areas. The study was conducted using a phantom model and surgical fluorescent microscope. A region of interest (ROI) was created for the vessel model and another ROI was created within 3 cm of that. With an ROI of 6.8 mm in the vessel phantom model, 10% intensity was confirmed, even though there was no fluorescent structure. Intensity decreased gradually as the ROI moved further from the vessel model. Our study results suggest that the presence of a high-intensity structure and the size of the ROI may affect quantitative intensity evaluations using ICG-VAG. Results of linear regression analysis indicate that the relationship of intensity (Y) and distance (X) is as follows: Y(real/A) = 29 Exp(-0.062X) + 164.3 Exp(-1.81X). The optical effect should be considered when performing an intraoperative intensity study with a surgical microscope.

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Section: Discussionsupporting

confidence: 85%

Optical effects on the surrounding structure during quantitative analysis using indocyanine green videoangiography: A phantom vessel study

Tsukiyama

Murai

Matano

et al. 2018

Journal of Biophotonics

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“…1,12 In particular, the use of intraoperative volumetric flow measurements and video-assisted indocyanine green (ICG), including the recent development of infrared local flow analysis, 16,17 have unequivocally shown their benefit. 2,5,13 This hemodynamic information, however, is only provided on a vascular level and gives no insight into the hemodynamic state at the brain tissue level, and it does not reveal changes in brain tissue perfusion immediately after bypass revascularization, especially in areas distant from the anastomosis. Therefore, it can only be assumed that the flow measured through the bypass graft is sufficient for the vascular territory downstream to maintain brain tissue function and integrity.…”

mentioning

confidence: 99%

Feasibility and safety of intraoperative BOLD functional MRI cerebrovascular reactivity to evaluate extracranial-to-intracranial bypass efficacy

Muscas

Niftrik

Fierstra

et al. 2019

Neurosurgical Focus

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Blood oxygenation level–dependent functional MRI cerebrovascular reactivity (BOLD-CVR) is a contemporary technique to assess brain tissue hemodynamic changes after extracranial- intracranial (EC-IC) bypass flow augmentation surgery. The authors conducted a preliminary study to investigate the feasibility and safety of intraoperative 3-T MRI BOLD-CVR after EC-IC bypass flow augmentation surgery. Five consecutive patients selected for EC-IC bypass revascularization underwent an intraoperative BOLD-CVR examination to assess early hemodynamic changes after revascularization and to confirm the safety of this technique. All patients had a normal postoperative course, and none of the patients exhibited complications or radiological alterations related to prolonged anesthesia time. In addition to intraoperative flow measurements of the bypass graft, BOLD-CVR maps added information on the hemodynamic status and changes at the brain tissue level. Intraoperative BOLD-CVR is feasible and safe in patients undergoing EC-IC bypass revascularization. This technique can offer immediate hemodynamic feedback on brain tissue revascularization after bypass flow augmentation surgery.

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“…This, together with intraoperative neuromonitoring (IONM), allows the surgeon to proof the efficiency of revascularization procedures and minimize the risk of ischemia. 23…”

Section: Discussionmentioning

confidence: 99%

Traumatic Distal Anterior Cerebral Artery Aneurysms – Pathomechanism and Revascularisation Strategies

Velz

Esposito

Regli

2021

Journal of Stroke and Cerebrovascular Diseases

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Intraoperative tools for cerebral bypass surgery

Cited by 15 publications

References 25 publications

Optical effects on the surrounding structure during quantitative analysis using indocyanine green videoangiography: A phantom vessel study

Optical effects on the surrounding structure during quantitative analysis using indocyanine green videoangiography: A phantom vessel study

Feasibility and safety of intraoperative BOLD functional MRI cerebrovascular reactivity to evaluate extracranial-to-intracranial bypass efficacy

Traumatic Distal Anterior Cerebral Artery Aneurysms – Pathomechanism and Revascularisation Strategies

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