Microscope-integrated quantitative analysis of intraoperative indocyanine green fluorescence angiography for blood flow assessment: first experience in 30 patients.

Abstract:

BACKGROUND:Intraoperative measurements of cerebral blood flow are of interest during vascular neurosurgery. Near-infrared indocyanine green (ICG) fluorescence angiography was introduced for visualizing vessel patency intraoperatively. However, quantitative information has not been available. OBJECTIVE:To report our experience with a microscope with an integrated dynamic ICG fluorescence analysis system supplying semiquantitative information on blood flow. METHODS:We recorded ICG fluorescence curves of cortex and cerebral vessels using software integrated into the surgical microscope (Flow 800 software; Zeiss Pentero) in 30 patients undergoing surgery for different pathologies. The following hemodynamic parameters were assessed: maximum intensity, rise time, time to peak, time to half-maximal fluorescence, cerebral blood flow index, and transit times from arteries to cortex. RESULTS:For patients without obvious perfusion deficit, maximum fluorescence intensity was 177.7 arbitrary intensity units (AIs; 5-mg ICG bolus), mean rise time was 5.2 seconds (range, 2.9-8.2 seconds; SD, 1.3 seconds), mean time to peak was 9.4 seconds (range, 4.9-15.2 seconds; SD, 2.5 seconds), mean cerebral blood flow index was 38.6 AI/s (range, 13.5-180.6 AI/s; SD, 36.9 seconds), and mean transit time was 1.5 seconds (range, 360 milliseconds-3 seconds; SD, 0.73 seconds). For 3 patients with impaired cerebral perfusion, time to peak, rise time, and transit time between arteries and cortex were markedly prolonged (>20, >9 , and >5 seconds). In single patients, the degree of perfusion impairment could be quantified by the cerebral blood flow index ratios between normal and ischemic tissue. Transit times also reflected blood flow perturbations in arteriovenous fistulas. CONCLUSION:Quantification of ICG-based fluorescence angiography appears to be useful for intraoperative monitoring of arterial patency and regional cerebral blood flow.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Kamp MA,Slotty P,Turowski B,Etminan N,Steiger HJ,Hänggi D,Stummer W

doi

10.1227/NEU.0b013e31822f7d7c

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

65-73; discussion 73-4

issue

1 Suppl Operative

eissn

0148-396X

issn

1524-4040

journal_volume

70

pub_type

杂志文章
  • Protocol of outcome evaluation for surgical release of carpal tunnel syndrome.

    abstract:OBJECTIVE:To propose and apply a protocol for assessing the outcome of surgery for carpal tunnel syndrome. METHODS:The protocol included a patient questionnaire that was self-administered before and 1 and 6 months after the operation to assess severity of symptoms (Boston questionnaire) and staging according to clinic...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000073421.92105.62

    authors: Reale F,Ginanneschi F,Sicurelli F,Mondelli M

    更新日期:2003-08-01 00:00:00

  • Microsurgical removal of intraventricular lesions using endoscopic visualization and stereotactic guidance.

    abstract:OBJECTIVE:To demonstrate the technique of stereotactic microsurgical endoscopic removal of intraventricular tumors or colloid cysts assisted by intraoperative computed tomography. METHODS:We adapted a tubular "ventriculoport" for stereotactic insertion of an endoscope into the ventricle. This facilitated microsurgical...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000146227.75138.08

    authors: Harris AE,Hadjipanayis CG,Lunsford LD,Lunsford AK,Kassam AB

    更新日期:2005-01-01 00:00:00

  • Microsurgery of the fourth ventricle: Part 1. Microsurgical anatomy.

    abstract::Operations on the 4th ventricle offer the potential for injury of the brain stem, cerebellum, cranial nerves, and major cerebellar arteries and veins. Twenty-five cadaver brains were examined using 3x to 25x magnification to define the relationship of these vital structures to the 4th ventricle. The 4th ventricle has ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198211000-00008

    authors: Matsushima T,Rhoton AL Jr,Lenkey C

    更新日期:1982-11-01 00:00:00

  • Endoscope-assisted supraorbital craniotomy for lesions of the interpeduncular fossa.

    abstract:OBJECTIVE:The supraorbital approach is well accepted for lesions in the anterior fossa, the sellar region, and the anterior circle of Willis. However, the usefulness of this approach has not yet been elucidated for lesions in the interpeduncular fossa. The technique of an endoscope-assisted, ipsi- and contralateral sup...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199901000-00062

    authors: Menovsky T,Grotenhuis JA,de Vries J,Bartels RH

    更新日期:1999-01-01 00:00:00

  • Promises and Perils of Artificial Intelligence in Neurosurgery.

    abstract::Artificial intelligence (AI)-facilitated clinical automation is expected to become increasingly prevalent in the near future. AI techniques may permit rapid and detailed analysis of the large quantities of clinical data generated in modern healthcare settings, at a level that is otherwise impossible by humans. Subsequ...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyz471

    authors: Panesar SS,Kliot M,Parrish R,Fernandez-Miranda J,Cagle Y,Britz GW

    更新日期:2020-07-01 00:00:00

  • Concepts and hypotheses: inflammatory hypothesis in the pathogenesis of cerebral cavernous malformations.

    abstract:OBJECTIVE:Cerebral cavernous malformations (CCMs) affect more than one million Americans, predisposing them to a lifetime risk of hemorrhagic stroke and epilepsy. A potential role of the immune response in this disease has not been postulated previously but is compelling given the unique antigenic milieu of CCM lesions...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/01.NEU.0000298897.38979.07

    authors: Shenkar R,Shi C,Check IJ,Lipton HL,Awad IA

    更新日期:2007-10-01 00:00:00

  • Somatosensory evoked potential changes in neuroendovascular procedures: incidence and association with clinical outcome in 873 patients.

    abstract:BACKGROUND:Neurophysiological monitoring is routinely used during neurosurgical procedures. Use of neurophysiological monitoring has extended to neuroendovascular procedures, but evidence of its impact on clinical outcome in this arena is limited. OBJECTIVE:To report the incidence of significant intraoperative somatos...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000510

    authors: Phillips JL,Chalouhi N,Jabbour P,Starke RM,Bovenzi CD,Rosenwasser RH,Wilent WB,Romo VM,Tjoumakaris SI

    更新日期:2014-11-01 00:00:00

  • Iatrogenic sciatic nerve injuries at buttock and thigh levels: the Louisiana State University experience review.

    abstract:OBJECTIVE:To provide an overview of iatrogenic sciatic nerve injuries at the buttock and thigh levels, and to analyze results of the treatment provided at Louisiana State University Health Sciences Center-New Orleans. METHODS:The data from 196 patients were reviewed retrospectively. All patients had iatrogenic sciatic...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000346265.17661.1E

    authors: Yeremeyeva E,Kline DG,Kim DH

    更新日期:2009-10-01 00:00:00

  • Involvement of the external carotid arteries in moyamoya disease: neuroradiological evaluation of 66 patients.

    abstract::Arterial stenoses and/or occlusions in moyamoya disease are mainly localized intracranially, although some instances of stenotic lesions of the extracranial arteries have been reported in some autopsy cases. We have reviewed the angiograms of 66 patients with moyamoya disease to investigate whether stenotic lesions ar...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199209000-00002

    authors: Hoshimaru M,Kikuchi H

    更新日期:1992-09-01 00:00:00

  • Carotid endarterectomy after noninvasive evaluation by duplex ultrasonography and magnetic resonance angiography.

    abstract::Recent studies documenting the efficacy of carotid endarterectomy (CEA) in selected patients provide further impetus for developing noninvasive techniques to evaluate carotid occlusive disease. Eliminating the morbidity due to preoperative angiography would further refine the treatment of this condition. Recent improv...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199404000-00007

    authors: Lustgarten JH,Solomon RA,Quest DO,Khanjdi AG,Mohr JP

    更新日期:1994-04-01 00:00:00

  • An extramedullary foramen magnum cavernous malformation presenting with acute subarachnoid hemorrhage: case report and literature review.

    abstract:OBJECTIVE AND IMPORTANCE:This case summarizes our experience with the first described intradural extramedullary cavernous malformation at the foramen magnum and reminds the neurosurgical community to consider cavernous malformations in the differential diagnosis for subarachnoid hemorrhage. CLINICAL PRESENTATION:A 21-...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/01.neu.0000148078.13726.83

    authors: Mocco J,Laufer I,Mack WJ,Winfree CJ,Libien J,Connolly ES Jr

    更新日期:2005-02-01 00:00:00

  • Meningiomas of the internal auditory canal.

    abstract:OBJECTIVE:Meningiomas arising primarily within the internal auditory canal (IAC) are notably rare. By far the most common tumors that are encountered in this region are neuromas. We report a series of eight patients with meningiomas of the IAC, analyzing the clinical presentations, surgical management strategies, and c...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/01.neu.0000126887.55995.e7

    authors: Nakamura M,Roser F,Mirzai S,Matthies C,Vorkapic P,Samii M

    更新日期:2004-07-01 00:00:00

  • Ruptured aneurysm at the origin of the accessory middle cerebral artery: case report.

    abstract::The accessory middle cerebral artery is a rare vascular anomaly of the brain. We describe a case of a ruptured aneurysm at the junction of the accessory middle cerebral artery and the horizontal portion of the anterior cerebral artery. The lesion was demonstrated by angiography and confirmed at surgery. No perforating...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199002000-00022

    authors: Kuwabara S,Naitoh H

    更新日期:1990-02-01 00:00:00

  • A prospective phase II trial of fractionated stereotactic intensity modulated radiotherapy with or without surgery in the treatment of patients with 1 to 3 newly diagnosed symptomatic brain metastases.

    abstract:BACKGROUND:Several studies have demonstrated that omitting the routine use of adjuvant whole-brain radiation therapy for patients with newly diagnosed brain metastases may be a reasonable first-line strategy. Retrospective evidence suggests that fractionated stereotactic radiotherapy (fSRT) may have a lower level of to...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000325

    authors: Ammirati M,Kshettry VR,Lamki T,Wei L,Grecula JC

    更新日期:2014-06-01 00:00:00

  • Central herniation revealed by focal decrease in blood flow without elevation of intracranial pressure: a case report.

    abstract::Until recently, in standard hospital settings the tissue blood supply could be inferred only from indirect measures such as assessment of the clinical signs and intracranial pressure (ICP) monitoring. This critical parameter can now be imaged directly with stable xenon-enhanced computed tomographic (CT) imaging. The p...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198510000-00018

    authors: Wozney P,Yonas H,Latchaw RE,Gur D,Good W

    更新日期:1985-10-01 00:00:00

  • Correlation of absorption coefficients with intracranial fluid protein concentrations and specific gravities.

    abstract::Samples of ventricular cerebrospinal fluid, tumor cyst fluid, and subdural fluid were obtained from 30 patients at operation. The protein concentration and the specific gravity of each sample were measured and the corresponding mean absorption numbers were calculated from the numerical printout of the preoperative com...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-197907010-00003

    authors: Salcman M

    更新日期:1979-07-01 00:00:00

  • Accessing the recesses of the fourth ventricle: comparison of tonsillar retraction and resection in the telovelar approach.

    abstract:OBJECTIVE:To compare the effectiveness of the telovelar approach with tonsillar manipulation for approaching the recesses of the fourth ventricle. METHODS:A telovelar approach was performed in 8 injected cadaveric heads. Areas of exposure were measured for the superolateral and lateral recesses. Horizontal angles were...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000348558.35921.4E

    authors: Jittapiromsak P,Sabuncuoglu H,Deshmukh P,Spetzler RF,Preul MC

    更新日期:2010-03-01 00:00:00

  • Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors.

    abstract::Intraoperative brain mapping techniques were used to localize language cortex, sensorimotor pathways, and seizure foci in children with supratentorial brain tumors. The methods of direct cortical and subcortical stimulation, in addition to electrocorticography, enabled us to maximize tumor resection, minimize morbidit...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-198911000-00015

    authors: Berger MS,Kincaid J,Ojemann GA,Lettich E

    更新日期:1989-11-01 00:00:00

  • Real-time atlas-based stereotactic neuronavigation.

    abstract:BACKGROUND:Surgery for tumors in eloquent brain faces immense challenges when attempting to maximize resection and avoid neurological deficits. OBJECTIVE:In order to give the surgeon real-time atlas-based anatomic information linked to the patient's anatomy, we developed a software-based interface between deformable a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000199

    authors: Vabulas M,Kumar VA,Hamilton JD,Martinez JJ,Rao G,Sawaya R,Prabhu SS

    更新日期:2014-01-01 00:00:00

  • Recent and Emerging Advances in Spinal Deformity.

    abstract:BACKGROUND:Over the last several decades, significant advances have occurred in the assessment and management of spinal deformity. OBJECTIVE:The primary focus of this narrative review is on recent advances in adult thoracic, thoracolumbar, and lumbar deformities, with additional discussions of advances in cervical def...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyw048

    authors: Smith JS,Shaffrey CI,Bess S,Shamji MF,Brodke D,Lenke LG,Fehlings MG,Lafage V,Schwab F,Vaccaro AR,Ames CP

    更新日期:2017-03-01 00:00:00

  • Glioma invasion in the central nervous system.

    abstract::Invading glioma cells seem to follow distinct anatomic structures within the central nervous system. Tumor cell dissemination may occur along structures, such as the basement membranes of blood vessels or the glial limitans externa, that contain extracellular matrix (ECM) proteins. Frequently, invasive glioma cells ar...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199608000-00001

    authors: Giese A,Westphal M

    更新日期:1996-08-01 00:00:00

  • Patients with moderate head injury: a prospective multicenter study of 315 patients.

    abstract:OBJECTIVE:To analyze the risk factors of worst outcome associated with moderate head injury. METHODS:Data on patients with moderate head injury were collected prospectively in 11 Italian neurosurgical units over a period of 18 months. Patients older than 18 years with blunt head injury and at least one Glasgow Coma Sc...

    journal_title:Neurosurgery

    pub_type: 杂志文章,多中心研究

    doi:10.1227/01.NEU.0000340796.18738.F7

    authors: Compagnone C,d'Avella D,Servadei F,Angileri FF,Brambilla G,Conti C,Cristofori L,Delfini R,Denaro L,Ducati A,Gaini SM,Stefini R,Tomei G,Tagliaferri F,Trincia G,Tomasello F

    更新日期:2009-04-01 00:00:00

  • Gamma knife surgery for facial nerve schwannomas.

    abstract:OBJECTIVE:Radical resection of facial nerve schwannomas classically implies a high risk of severe facial palsy. Owing to the rarity of facial palsy after gamma knife surgery (GKS) of vestibular schwannomas, functional evaluation after GKS seems rational in this specific group of patients. To our knowledge, no previous ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000249282.46514.DA

    authors: Litre CF,Gourg GP,Tamura M,Mdarhri D,Touzani A,Roche PH,Régis J

    更新日期:2007-05-01 00:00:00

  • Cerebral gangliogliomas during childhood.

    abstract::We have reviewed our experience with gangliogliomas treated in the post-computed tomography (CT) era at the Children's Hospital of Philadelphia. Of 234 newly histologically verified neoplasms seen at our institution since 1975, 10 (4.3%) were gangliogliomas of the cerebral hemispheres. The presenting complaint was sei...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198308000-00003

    authors: Sutton LN,Packer RJ,Rorke LB,Bruce DA,Schut L

    更新日期:1983-08-01 00:00:00

  • Clinical problem-solving: brachial plexus closed injury and reconstruction.

    abstract:OBJECTIVE:Current management of severe brachial plexus injury has undergone recent modifications, and surgical options have expanded. METHODS:The case of a man with a severe closed brachial plexus injury resulting from a motorcycle accident is presented. The patient is found to have upper root avulsions that deprive h...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000333305.57060.00

    authors: Ranalli NJ,Kline DG,McGarvey ML,Boulis NM,Zager EL

    更新日期:2008-06-01 00:00:00

  • Role of multiple cerebral microthrombosis in symptomatic cerebral vasospasm: with a case report.

    abstract::In our studies of the pathogenesis of cerebral vasospasm, we have been emphasizing that microthrombosis may play an important role in the induction of cerebral ischemic symptoms or cerebral infarction. In this report, multiple microthrombi are demonstrated histologically to be a major cause of cerebral infarction in t...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198308000-00018

    authors: Suzuki S,Suzuki M,Iwabuchi T,Kamata Y

    更新日期:1983-08-01 00:00:00

  • Cerebral Aneurysms in Autosomal Dominant Polycystic Kidney Disease: A Comparison of Management Approaches.

    abstract:BACKGROUND:Autosomal dominant polycystic kidney disease (ADPKD) is a risk factor for formation of intracranial aneurysms (IAs), though the ideal screening and treatment strategies in this population are unclear. OBJECTIVE:To report outcomes of observation, open surgical, or endovascular management of ruptured and unru...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyy336

    authors: Wilkinson DA,Heung M,Deol A,Chaudhary N,Gemmete JJ,Thompson BG,Pandey AS

    更新日期:2019-06-01 00:00:00

  • Rupture of a pseudoaneurysm of the posterior meningeal artery at its anomalous origin from the posteroinferior cerebellar artery: case report.

    abstract:OBJECTIVE:The posterior meningeal artery (PMA) normally arises from the vertebral artery; however, its origin varies considerably as the result of its embryological development. This gains clinical significance when associated with vascular pathology. CLINICAL PRESENTATION:A 65-year-old man presented to his local hosp...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000325256.72308.AF

    authors: Aronson JP,Murray PJ,Ogilvy CS

    更新日期:2008-09-01 00:00:00

  • Primary pituitary carcinoma: a clinical pathological study.

    abstract::A 60-year-old woman presented with a history of headache and rapidly progressive complete bilateral ophthalmoplegia. Her endocrine function was normal. Radiographic studies revealed signs of diffuse destruction of the sella turcica by a tumor without suprasellar extension. Biopsies of the lesion within the sphenoid si...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Nudleman KL,Choi B,Kusske JA

    更新日期:1985-01-01 00:00:00

  • Refined and simplified surgical landmarks for the MacCarty keyhole and orbitozygomatic craniotomy.

    abstract:BACKGROUND:Precise placement of the MacCarty keyhole, a burr hole simultaneously exposing the anterior cranial fossa floor and orbit, provides accurate, efficient entry for orbitozygomatic and supraorbital craniotomies. To locate the optimal keyhole site, previous studies have used superficial landmarks that, in our ex...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000369650.69583.9C

    authors: Tubbs RS,Loukas M,Shoja MM,Cohen-Gadol AA

    更新日期:2010-06-01 00:00:00