Target-controlled infusion technique with indocyanine green videoangiography for radial artery graft

Murai, Yasuo; Mizunari, Takayuki; Koketsu, Kenta; Tateyama, Kojiro; Kobayashi, Shiro; Umeoka, Katsuya; Teramoto, Akira; Morita, Akio

doi:10.1016/j.clineuro.2014.01.015

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…Even in emergency operations under conditions that do not allow preoperative cerebral blood flow testing, the risk of postoperative complications, including hyperperfusion and ischemic complications, has been determined to be reduced by intraoperative maneuvers such as MCA pressure measurements, additional STA-MCA bypass, and indocyanine green fluorescence. 19 , 22 , 23 ) On the other hand, when surgery is performed during the acute phase of trauma, it is necessary to consider the difficulty of surgery due to decreased bypass patency caused by hypercoagulability, 24 - 26 ) swelling of subcutaneous tissues at the surgical site, and subcutaneous bleeding. The risk of abducens nerve palsy associated with internal carotid artery occlusion, 27 ) even if temporary, should also be considered, as was observed in this present case.…”

Section: Discussionmentioning

confidence: 99%

A Case of Ruptured Carotid Traumatic Blood Blister-like Aneurysm

MATSUMOTO,

NAKAE,

MATANO

et al. 2023

NMC Case Report Journal

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Ruptured cerebral aneurysms that occur in the anterior wall of the internal carotid artery (ICA) are known as blood blister-like aneurysms (BBAs); they have been reported to account for 0.3% to 1% of all ruptured ICA aneurysms. In this report, we describe the treatment of an unusual traumatic BBA (tBBA) with high-flow bypass using a radial artery graft, which resulted in a favorable outcome. A 59-year-old female suffered from an acute epidural hematoma, traumatic subarachnoid hemorrhage, and traumatic carotid-cavernous sinus fistula (tCCF) after being involved in a motor vehicle accident. Her angiography results showed tCCF and a tBBA on the anterior wall of the right ICA. On the fourth day after injury, we found rebleeding from the tBBA and performed an emergency high-flow bypass using a radial artery graft with lesion trapping as a curative procedure for the tCCF and tBBA. Postoperatively, right abducens nerve palsy appeared, but no other neurological symptoms were noted; the patient was thereafter transferred to a rehabilitation hospital 49 days after injury. Traumatic ICA aneurysms commonly occur close to the anterior clinoid process, form within 1 to 2 weeks of injury, and often rupture around 2 weeks after trauma. This case was considered rare as the ICA was likely injured and bleeding at the time of injury, resulting in a form of tBBA; this allowed early detection and appropriate treatment that resulted in a good outcome.

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Section: Discussionmentioning

confidence: 99%

A Case of Ruptured Carotid Traumatic Blood Blister-like Aneurysm

MATSUMOTO,

NAKAE,

MATANO

et al. 2023

NMC Case Report Journal

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The feasibility of detecting cerebral blood flow direction using the indocyanine green video angiography

et al. 2016

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The intraoperative confirmation of blood flow direction is necessary in cerebral vascular surgery. Using indocyanine green video angiography (ICG-VAG) with the FLOW 800 system, we examined the transit time of the blood vessel of interest and semiquantitatively evaluated the delay time (T1/2max) from indocyanine green (ICG) injection into the donor artery in reconstructive surgery and the middle cerebral artery (MCA) in aneurysmal surgery. The direction of cerebral blood flow (CBF), which can often be confirmed by ICG-VAG, may be more difficult to determine with faster blood flow. Here, we report our findings regarding the feasibility of detecting CBF direction using the FLOW 800 system. Twenty patients undergoing superficial temporal artery (STA) to MCA anastomosis for carotid occlusive disease and 13 patients with a small MCA aneurysm clipping were evaluated using the T1/2max, semiquantitative method with the FLOW 800 system. In STA-MCA anastomosis cases, the regions of interest (ROIs) included: the proximal donor STA and a region more than 10 mm on the distal side of the donor STA near the anastomosis site. In MCA aneurysms, the ROIs included the proximal M1 and distal M2 sides of the MCA aneurysm. T1/2max was significantly shorter for the proximal sites compared to the distal sites for all subjects (ps < 0.01). T1/2max was shorter for all subjects in the proximal sites. The direction of CBF can be determined using the FLOW 800 system.

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