nach oben

Acta Neurochirurgica

Erschienen in:

01.04.2013 | Clinical Article - Vascular

Semiquantitative analysis of indocyanine green videoangiography for cortical perfusion assessment in superficial temporal artery to middle cerebral artery anastomosis

verfasst von: Haruto Uchino, Toshitaka Nakamura, Kiyohiro Houkin, Jun-ichi Murata, Hisatoshi Saito, Satoshi Kuroda

Erschienen in: Acta Neurochirurgica | Ausgabe 4/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Postoperative hyperperfusion may lead to severe neurological complications after superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis. However, there are no reliable modalities to predict the occurrence of postoperative hyperperfusion during surgery. The purpose of this study is to evaluate whether a semiquantitative analysis of indocyanine green (ICG) videoangiography could be useful in predicting postoperative hyperperfusion after STA-MCA anastomosis.

Methods

This study included seven patients who underwent STA-MCA anastomosis due to occlusive carotid artery diseases. During surgery, ICG videoangiography was performed before and after bypass procedures, and ICG intensity–time curves were semiquantitatively analyzed to evaluate hemodynamic changes by calculating maximum intensity, time to peak (TTP), and blood flow index (BFI).

Results

Maximum intensity significantly increased from 252.6 ± 132.5 to 351.7 ± 151.9 after bypass (p < 0.001). TTP was significantly shortened from 12.9 ± 4.4 s to 9.8 ± 3.7 s (p < 0.001). Furthermore, BFI significantly increased from 33.9 ± 28.1 to 74.6 ± 88.4 (p < 0.05). Postoperative hyperperfusion was observed in five of seven patients 1 day after surgery. The ratio of BFI before and after bypass procedures was significantly higher in patients with postoperative hyperperfusion than those without, 2.5 ± 1.1 and 1.5 ± 0.4, respectively (p = 0.013).

Conclusions

These findings suggest that semiquantitative analysis of ICG videoangiography is helpful in predicting occurrence of hyperperfusion after STA-MCA anastomosis in patients with occlusive carotid artery diseases.

Hatazawa J, Fujita H, Kanno I, Satoh T, Iida H, Miura S, Murakami M, Okudera T, Inugami A, Ogawa (1995) Regional cerebral blood flow, blood volume, oxygen extraction fraction, and oxygen utilization rate in normal volunteers measured by the autoradiographic technique and the single breath inhalation method. Ann Nucl Med 9:15–21PubMedCrossRef

Heros RC, Scott RM, Kistler JP, Ackerman RH, Conner ES (1984) Temporary neurological deterioration after extracranial-intracranial bypass. Neurosurgery 15:178–185PubMedCrossRef

Kawamata T, Kawashima A, Yamaguchi K, Hori T, Okada Y (2011) Usefulness of intraoperative laser Doppler flowmetry and thermography to predict a risk of postoperative hyperperfusion after superficial temporal artery-middle cerebral artery bypass for moyamoya disease. Neurosurg Rev 34:355–362, discussion 362PubMedCrossRef

Kawamata T, Okada Y, Kawashima A, Yoneyama T, Yamaguchi K, Ono Y, Hori T (2009) Postcarotid endarterectomy cerebral hyperperfusion can be prevented by minimizing intraoperative cerebral ischemia and strict postoperative blood pressure control under continuous sedation. Neurosurgery 64:447–453, discussion 453–444PubMedCrossRef

Killory BD, Nakaji P, Gonzales LF, Ponce FA, Wait SD, Spetzler RF (2009) Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green angiography during cerebral arteriovenous malformation surgery. Neurosurgery 65:456–462, discussion 462PubMedCrossRef

Kuebler WM, Sckell A, Habler O, Kleen M, Kuhnle GE, Welte M, Messmer K, Goetz AE (1998) Noninvasive measurement of regional cerebral blood flow by near-infrared spectroscopy and indocyanine green. J Cereb Blood Flow Metab 18:445–456PubMedCrossRef

Kuroda S, Houkin K (2012) Bypass surgery for moyamoya disease: concept and essence of surgical techniques. Neurol Med Chir (Tokyo) 52:287–294

Kuroda S, Houkin K, Ishikawa T, Nakayama N, Ikeda J, Ishii N, Kamiyama H, Iwasaki Y (2004) Determinants of intellectual outcome after surgical revascularization in pediatric moyamoya disease: a multivariate analysis. Childs Nerv Syst 20:302–308PubMedCrossRef

Kuroda S, Houkin K, Kamiyama H, Mitsumori K, Iwasaki Y, Abe H (2001) Long-term prognosis of medically treated patients with internal carotid or middle cerebral artery occlusion: can acetazolamide test predict it? Stroke 32:2110–2116PubMedCrossRef

10.

Kuroda S, Kamiyama H, Abe H, Asaoka K, Mitsumori K (1994) Temporary neurological deterioration caused by hyperperfusion after extracranial-intracranial bypass–case report and study of cerebral hemodynamics. Neurol Med Chir (Tokyo) 34:15–19CrossRef

11.

Kuroda S, Kamiyama H, Abe H, Houkin K, Isobe M, Mitsumori K (1993) Acetazolamide test in detecting reduced cerebral perfusion reserve and predicting long-term prognosis in patients with internal carotid artery occlusion. Neurosurgery 32:912–918, discussion 918–919PubMedCrossRef

12.

Kuroda S, Kamiyama H, Abe H, Yamauchi T, Kohama Y, Houkin K, Mitsumori K (1993) Cerebral blood flow in children with spontaneous occlusion of the circle of Willis (moyamoya disease): comparison with healthy children and evaluation of annual changes. Neurol Med Chir (Tokyo) 33:434–438CrossRef

13.

Kuroda S, Shiga T, Houkin K, Ishikawa T, Katoh C, Tamaki N, Iwasaki Y (2006) Cerebral oxygen metabolism and neuronal integrity in patients with impaired vasoreactivity attributable to occlusive carotid artery disease. Stroke 37:393–398PubMedCrossRef

14.

Kuroda S, Shiga T, Ishikawa T, Houkin K, Narita T, Katoh C, Tamaki N, Iwasaki Y (2004) Reduced blood flow and preserved vasoreactivity characterize oxygen hypometabolism due to incomplete infarction in occlusive carotid artery diseases. J Nucl Med 45:943–949PubMed

15.

Kuroiwa T, Kajimoto Y, Ohta T (2001) Development and clinical application of near-infrared surgical microscope: preliminary report. Minim Invasive Neurosurg 44:240–242PubMedCrossRef

16.

Ogasawara K, Ogawa A (2006) JET study (Japanese EC-IC bypass trial). Nihon Rinsho 64(Suppl 7):524–527PubMed

17.

Pena-Tapia PG, Kemmling A, Czabanka M, Vajkoczy P, Schmiedek P (2008) Identification of the optimal cortical target point for extracranial-intracranial bypass surgery in patients with hemodynamic cerebrovascular insufficiency. J Neurosurg 108:655–661PubMedCrossRef

18.

Perbeck L, Lewis DH, Thulin L, Tyden G (1985) Correlation between fluorescein flowmetry, 133Xenon clearance and electromagnetic flow measurement: a study in the intestine of the pig. Clin Physiol 5:293–299PubMedCrossRef

19.

Raabe A, Beck J, Gerlach R, Zimmermann M, Seifert V (2003) Near-infrared indocyanine green video angiography: a new method for intraoperative assessment of vascular flow. Neurosurgery 52:132–139, discussion 139PubMed

20.

Raabe A, Nakaji P, Beck J, Kim LJ, Hsu FP, Kamerman JD, Seifert V, Spetzler RF (2005) Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery. J Neurosurg 103:982–989PubMedCrossRef

21.

Schuette AJ, Dannenbaum MJ, Cawley CM, Barrow DL (2011) Indocyanine green videoangiography for confirmation of bypass graft patency. J Korean Neurosurg Soc 50:23–29PubMedCrossRef

22.

Terborg C, Groschel K, Petrovitch A, Ringer T, Schnaudigel S, Witte OW, Kastrup A (2009) Noninvasive assessment of cerebral perfusion and oxygenation in acute ischemic stroke by near-infrared spectroscopy. Eur Neurol 62:338–343PubMedCrossRef

23.

van Mook WN, Rennenberg RJ, Schurink GW, van Oostenbrugge RJ, Mess WH, Hofman PA, de Leeuw PW (2005) Cerebral hyperperfusion syndrome. Lancet Neurol 4:877–888PubMedCrossRef

24.

Woitzik J, Horn P, Vajkoczy P, Schmiedek P (2005) Intraoperative control of extracranial-intracranial bypass patency by near-infrared indocyanine green videoangiography. J Neurosurg 102:692–698PubMedCrossRef

25.

Woitzik J, Pena-Tapia PG, Schneider UC, Vajkoczy P, Thome C (2006) Cortical perfusion measurement by indocyanine-green videoangiography in patients undergoing hemicraniectomy for malignant stroke. Stroke 37:1549–1551PubMedCrossRef

26.

Yamaguchi K, Kawamata T, Kawashima A, Hori T, Okada Y (2010) Incidence and predictive factors of cerebral hyperperfusion after extracranial-intracranial bypass for occlusive cerebrovascular diseases. Neurosurgery 67:1548–1554, discussion 1554PubMedCrossRef

27.

Yoshimoto T, Houkin K, Kuroda S, Abe H, Kashiwaba T (1997) Low cerebral blood flow and perfusion reserve induce hyperperfusion after surgical revascularization: case reports and analysis of cerebral hemodynamics. Surg Neurol 48:132–138, discussion 138–139PubMedCrossRef

Titel: Semiquantitative analysis of indocyanine green videoangiography for cortical perfusion assessment in superficial temporal artery to middle cerebral artery anastomosis
verfasst von: Haruto Uchino
Toshitaka Nakamura
Kiyohiro Houkin
Jun-ichi Murata
Hisatoshi Saito
Satoshi Kuroda
Publikationsdatum: 01.04.2013
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 4/2013
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-012-1575-y

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2013

Z. Ghogawala, A. A. Krishnaney, M. P. Steinmetz, H. H. Batjer, E. C. Benzel: The evidence for neurosurgery

Evidence-based clinical management and utilization of new technology in European neurosurgery

Evaluation of prognostic factors as predictor of AVMS obliteration after Gamma Knife radiosurgery

The combined use of mechanical thrombectomy devices is feasible for treating acute carotid terminus occlusion

Thrombosis and recanalization of a blister-like aneurysm: letter to the editor