Kenji Fukuda1, Hiroharu Kataoka1, Norio Nakajima1, Jun Masuoka1, Tetsu Satow1, Koji Iihara2. 1. Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 2. Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: kiihara@ns.med.kyushu-u.ac.jp.
Abstract
OBJECTIVE: To evaluate the quantitative assessment of flow dynamics during surgery for arteriovenous malformations (AVMs) with FLOW 800 with indocyanine green videoangiography. METHODS: Changes in flow dynamics in the superficial AVM components (feeder, nidus, and drainer), the adjacent cortical artery, and the cortical vein surrounding AVM were evaluated. Analysis was performed at predissection, postclipping of the feeders, and postresection of the nidus with the use of quantitative values of the maximum fluorescence intensity, time to half-maximum fluorescence intensity (T1/2 FI), and the fluorescence intensity rate at T1/2 FI semiautomatically obtained with the use of FLOW 800 software. RESULTS: FLOW 800 assessments were performed in 7 cases. The time difference between the T1/2 FI, defined as transit time, in the cortical artery and the drainer was prolonged from 0.08 ± 0.65 seconds to 2.63 ± 1.79 seconds (P < 0.0001) at postfeeder clipping phase. The transit time between the cortical artery and the cortical vein was reduced to 3.76 ± 1.37 seconds at post feeder clipping phase (P = 0.024) and 2.63 ± 0.80 seconds at final phase (P = 0.005) compared with 4.56 ± 1.47 seconds at predissection phase. The maximum intensity and the fluorescence intensity rate at T1/2 FI were not significantly different at these phases, excluding the maximum intensity of the drainer decreasing from 533 ± 271 to 399 ± 217 (P = 0.006) at post feeder clipping phase. CONCLUSION: FLOW 800 analysis with indocyanine green videoangiography provides the real-time hemodynamic status of the AVMs and adjacent brain at various stages of resection. This technique is feasible to resect AVMs more safely and convincingly.
OBJECTIVE: To evaluate the quantitative assessment of flow dynamics during surgery for arteriovenous malformations (AVMs) with FLOW 800 with indocyanine green videoangiography. METHODS: Changes in flow dynamics in the superficial AVM components (feeder, nidus, and drainer), the adjacent cortical artery, and the cortical vein surrounding AVM were evaluated. Analysis was performed at predissection, postclipping of the feeders, and postresection of the nidus with the use of quantitative values of the maximum fluorescence intensity, time to half-maximum fluorescence intensity (T1/2 FI), and the fluorescence intensity rate at T1/2 FI semiautomatically obtained with the use of FLOW 800 software. RESULTS: FLOW 800 assessments were performed in 7 cases. The time difference between the T1/2 FI, defined as transit time, in the cortical artery and the drainer was prolonged from 0.08 ± 0.65 seconds to 2.63 ± 1.79 seconds (P < 0.0001) at postfeeder clipping phase. The transit time between the cortical artery and the cortical vein was reduced to 3.76 ± 1.37 seconds at post feeder clipping phase (P = 0.024) and 2.63 ± 0.80 seconds at final phase (P = 0.005) compared with 4.56 ± 1.47 seconds at predissection phase. The maximum intensity and the fluorescence intensity rate at T1/2 FI were not significantly different at these phases, excluding the maximum intensity of the drainer decreasing from 533 ± 271 to 399 ± 217 (P = 0.006) at post feeder clipping phase. CONCLUSION: FLOW 800 analysis with indocyanine green videoangiography provides the real-time hemodynamic status of the AVMs and adjacent brain at various stages of resection. This technique is feasible to resect AVMs more safely and convincingly.
Authors: Jonathan T Elliott; Alisha V Dsouza; Scott C Davis; Jonathan D Olson; Keith D Paulsen; David W Roberts; Brian W Pogue Journal: Biomed Opt Express Date: 2015-09-03 Impact factor: 3.732
Authors: Nikolay L Martirosyan; Jesse Skoch; Jeffrey R Watson; G Michael Lemole; Marek Romanowski; Rein Anton Journal: Neurosurgery Date: 2015-06 Impact factor: 4.654
Authors: Evgenii G Belykh; Xiaochun Zhao; Claudio Cavallo; Michael A Bohl; Kaan Yagmurlu; Joseph L Aklinski; Vadim A Byvaltsev; Nader Sanai; Robert F Spetzler; Michael T Lawton; Peter Nakaji; Mark C Preul Journal: Cureus Date: 2018-07-30