FLOW 800 allows visualization of hemodynamic changes after extracranial-to-intracranial bypass surgery but not assessment of quantitative perfusion or flow.

Abstract:

BACKGROUND:FLOW 800 delivers a color-coded map for snapshot visualization of the temporal distribution dynamics after indocyanine green angiography with post hoc calculation of FLOW 800-specific hemodynamic parameters. However, the value of these parameters regarding quantitative flow assessment remains unclear. OBJECTIVE:To determine the value of FLOW 800-specific hemodynamic parameters in neurosurgical patients that permit assessment of hemodynamic changes within the microcirculation and macrocirculation. METHODS:FLOW 800 was performed in 25 patients undergoing superficial temporal artery to middle cerebral artery bypass grafting and in 5 patients undergoing high- or intermediate-flow bypass grafting. The time to half-maximum fluorescence (t1/2max) and the cerebral blood flow index were calculated in the recipient vessel (macrocirculation) and the cortical territory (microcirculation) surrounding the anastomosis. For further evaluation, FLOW 800-specific hemodynamic parameters were compared with cortical laser speckle imaging and quantitative Doppler flow within the graft. RESULTS:FLOW 800 provided color-coded information on the temporospatial distribution dynamics of the dye with excellent assessment of bypass patency. In the recipient vessel and in the cortical territory surrounding the anastomosis, FLOW 800 detected hemodynamic changes after superficial temporal artery to middle cerebral artery bypass grafting in terms of a significant decrease in t1/2max and increase in cerebral blood flow index. Interestingly, comparison of t1/2max with semiquantitative laser speckle imaging-specific cortical perfusion within the microcirculation demonstrated poor agreement, and neither t1/2max nor the cerebral blood flow index within the graft correlated with quantitative graft flow assessed by Doppler. CONCLUSION:FLOW 800 may detect procedure-related hemodynamic changes within the microcirculation and macrocirculation but should not be used as a stand-alone tool for quantitative flow assessment.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Prinz V,Hecht N,Kato N,Vajkoczy P

doi

10.1227/NEU.0000000000000277

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

231-8; discussion 238-9

eissn

0148-396X

issn

1524-4040

journal_volume

10 Suppl 2

pub_type

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