Use of a Yaşargil Mirror as an Adjunct to Indocyanine Green Angiography to Evaluate the Patency of Elusive Posterior Communicating Arteries During Aneurysm Clipping

Wilson, Jason; Screven, Ryan; Volk, Jerome; Payner, Troy D.

doi:10.1227/neu.0b013e318257d0c6

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…Wilson et al reported their experience with the use of a Yarargil mirror during ICG-VA to elucidate medially located vessels in two cases with PComA aneurysms. [6] PComA and anterior choroidal artery (AChA) are sometimes elusive but must be clearly visualized before and after clipping of these aneurysms as their injury may lead to the grave situation. [21,22] Besides these two main branches by which a PComA aneurysm is flanked, there are important medially located perforators from PComA and ICA, which cannot be seen under microscope without significant retraction of the ICA and the aneurysm.…”

Section: Advantages Of Endoscope Assisted Microsurgerymentioning

confidence: 99%

“…Unfortunately, ICG-VA visualization is limited to the vessels directly observed under microscope. To have a better view of the vessels hidden beyond the aneurysm, some authors have utilized Yasargil mirror in combination with ICG-VA.[ 6 ] Another alternative to evaluate the hidden vessels is endoscopy. So far, endoscope-assisted microsurgery of aneurysms has become a routine practice in many centers, but only small case series have been published addressing its value in neurovascular operations.…”

Section: Introductionmentioning

confidence: 99%

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Role of endoscopy in multi-modality monitoring during aneurysm surgery: A single center experience with 175 consecutive unruptured aneurysms

et al. 2015

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Objective and Background:Unruptured aneurysm surgery is a challenge to all vascular neurosurgeons as the patient is asymptomatic and no even slight neurological deficits should be expected postoperatively. To this aim, multi-modality checking of the vessels during the surgery is highly recommended to assure of the patency of the parent and perforator arteries next to an aneurysm. In this paper, we present our experience in the last 1.5 years with emphasis on the role of endoscope assisted microsurgery.Methods:One hundred and seventy-five patients with unruptured intracranial aneurysms were operated in our institute in the last 1½ years. All patients underwent endoscope assisted microsurgery with pre- and post-clipping indocyanine green angiography. In selected cases, motor evoked potential monitoring was implemented.Results:No mortality was observed in this period, and only 6 patients (3.4%) suffered new permanent neurological deficits postoperatively. Our illustrative cases show how endoscopy may help the surgeon to visualize hidden vessels behind and medial to an aneurysm.Conclusions:Our results indicated that multi-modality monitoring during unruptured aneurysm surgeries is associated with excellent outcome. Endoscope is able to show blind corners during aneurysm surgery which cannot be routinely observed with microscope and its application in aneurysm surgery assists the surgeon to make certain of complete neck clipping and preservation of perforating arteries around the aneurysm.

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Section: Advantages Of Endoscope Assisted Microsurgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of endoscopy in multi-modality monitoring during aneurysm surgery: A single center experience with 175 consecutive unruptured aneurysms

et al. 2015

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“…However, there are few reports on whether the intraoperative application can reduce related postoperative complications and improve the prognosis and its shortcomings around the world. Meanwhile, there are also few scholars combine artificial intelligence algorithms in cerebral angiography [ 17 ]. Therefore, a cerebral angiography under the Otsu algorithm was adopted here to explore its therapeutic advantages and prognostic effects in the design of nursing cooperation plan for ICAC.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Angiography under Artificial Intelligence Algorithm in the Design of Nursing Cooperation Plan for Intracranial Aneurysm Patients in Craniotomy Clipping

Xie²,

Zhang

et al. 2022

Computational and Mathematical Methods in Medicine

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This research was to investigate the value of indocyanine green angiography (ICGA) based on maximum interclass variance (Otsu) method in the nursing plan of intracranial aneurysm clipping (ICAC) for intracranial aneurysm patients. An Otsu algorithm was selected to optimize the original images with the optimal threshold. In addition, the algorithm was applied to ICGA images of 86 patients with intracranial aneurysms, who were randomly divided into an experimental group (using ICGA + ICAC+ perioperative nursing) and a control group (ICAC + conventional nursing), to observe the clinical indicators, treatment, complications, nursing satisfaction, and quality of life of patients in two groups. The results showed that the mean square error (MSE), structural similarity (SSIM), and shape error (SE) were 3.71, 0.84, and 0.47, respectively. The length of hospital stay in the experimental group ( 19.9 ± 3.5 days) was significantly shorter than that in the control group ( 23.2 ± 3.0 days), the rate of excellent treatment was significantly higher than that in the control group, and the incidence of complications was lower. WHOQOL-BREF scores of the two groups after nursing intervention were higher than before, and the score in the experimental group was higher than the control group. In addition, the nursing satisfaction was also significantly higher in the experimental group, and the difference was statistically significant ( P < 0.05 ). In conclusion, ICGA based on the Otsu method could effectively evaluate the cerebrovascular morphology during craniotomy and ICAP and improve the surgical efficacy. Combined with perioperative nursing intervention, it could greatly reduce the incidence of postoperative complications, improve the treatment effect and quality of life, and enhance the long-term prognosis.

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Use of a Yaşargil Mirror as an Adjunct to Indocyanine Green Angiography to Evaluate the Patency of Elusive Posterior Communicating Arteries During Aneurysm Clipping

Abstract: Although ICGA can be very useful during aneurysm surgery, it is limited to vessels directly visualized in the surgical field. A Yaşargil movable mirror can be used during ICGA to visualize elusive vessels, in these cases on the ventromedial surface of the internal carotid artery.

Cited by 2 publications

References 7 publications

Role of endoscopy in multi-modality monitoring during aneurysm surgery: A single center experience with 175 consecutive unruptured aneurysms

Role of endoscopy in multi-modality monitoring during aneurysm surgery: A single center experience with 175 consecutive unruptured aneurysms

Cerebral Angiography under Artificial Intelligence Algorithm in the Design of Nursing Cooperation Plan for Intracranial Aneurysm Patients in Craniotomy Clipping

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