Abstract:
INTRODUCTION:The quality of surgical treatment of intracranial aneurysms is determined by complete aneurysm occlusion and restoration of flow in the parent, branching and perforating vessels. In postoperative digital subtraction angiography (DSA), unexpected aneurysm residuals and vessel occlusions are frequently detected. Here, the value of two nearly noninvasive and cost-effective techniques for intraoperative flow evaluation (near-infrared indocyanine green video angiography (ICG-VA) and microvascular Doppler sonography (mDs)) is investigated in a prospective study. PATIENTS AND METHODS:Over a period of 10 months, the authors surgically clipped 50 aneurysms under intraoperative pre- and post-clipping evaluation of flow in the parent, branching and perforating vessels and the aneurysm sack by the two techniques. Intraoperative applicability of each technique was compared to each other and to postoperative digital subtraction angiography as standard evaluation technique. RESULTS:Forty-five aneurysms were totally occluded without vessel compromise (90%). Intraoperatively, ICG-VA was considered useful in 43 cases (86%) and mDs in 44 cases (88%), respectively. Both techniques could compensate each other's weak points to a certain degree; but two branch occlusions (4%) and three neck remnants (6%) were revealed by postoperative DSA. CONCLUSION:Both techniques have specific drawbacks that could be compensated by each other, to a certain extent. Intraoperatively, ICG-VA and mDs should not be considered competitive, but complementary. This study implicates that the combination of both applications on a routine basis assures the quality of aneurysm surgery by nearly noninvasive and cost-effective techniques. However, DSA remains the gold standard for evaluation of aneurysm occlusion.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Fischer G,Stadie A,Oertel JMdoi
10.1007/s00701-010-0723-5subject
Has Abstractpub_date
2010-09-01 00:00:00pages
1519-25issue
9eissn
0001-6268issn
0942-0940journal_volume
152pub_type
杂志文章abstract::The authors present the case of a 66-year-old female who developed progressive pulsating exophthalmos, a bruit, and conjunctival chemosis 7 months after a head injury. These symptoms, though highly suspicious of carotid cavernous fistula, were caused by an arteriovenous fistula (AVF) between the inferolateral trunk (I...
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journal_title:Acta neurochirurgica
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更新日期:1996-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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doi:10.1007/s00701-010-0778-3
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pub_type: 杂志文章,多中心研究
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更新日期:2010-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00701-019-03835-2
更新日期:2019-04-01 00:00:00
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