Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green Videoangiography

Intraoperative indocyanine green (ICG) videoangiography is widely used in patients undergoing neurosurgery. FLOW800 is a recently developed analytical tool for ICG videoangiography to assess semi-quantitative flow dynamics; however, its efficacy is unknown. In this study, we evaluated its functional...

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Main Authors: Naoki Kato, Vincent Prinz, Julius Dengler, Peter Vajkoczy
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Stroke Research and Treatment
Online Access:http://dx.doi.org/10.1155/2019/7292304
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author Naoki Kato
Vincent Prinz
Julius Dengler
Peter Vajkoczy
author_facet Naoki Kato
Vincent Prinz
Julius Dengler
Peter Vajkoczy
author_sort Naoki Kato
collection DOAJ
description Intraoperative indocyanine green (ICG) videoangiography is widely used in patients undergoing neurosurgery. FLOW800 is a recently developed analytical tool for ICG videoangiography to assess semi-quantitative flow dynamics; however, its efficacy is unknown. In this study, we evaluated its functionality in the assessment of flow dynamics of arteriovenous malformation (AVM) through ICG videoangiography under clinical settings. ICG videoangiography was performed in the exposed AVM in eight patients undergoing surgery. FLOW800 analysis was applied directly, and gray-scale and color-coded maps of the surgical field were obtained. After surgery, a region of interest was placed on the individual vessels to obtain time-intensity curves. Parameters of flow dynamics, including the maximum intensity, transit time, and cerebral blood flow index, were calculated using the curves. The color-coded maps provided high-resolution images; however, reconstruction of colored images was restricted by the depth, approach angle, and brain swelling. Semi-quantitative parameters were similar among the feeders, niduses, and drainers. However, a higher cerebral blood flow index was observed in the feeders of large AVM (>3 cm) than in those of small AVM (P < 0.05). Similarly, the cerebral blood flow index values were positively correlated with the nidus volume (P < 0.01). FLOW800 enabled visualization of the AVM structure and safer resection, except in case of deep-seated AVM. Moreover, semi-quantitative values in the individual vessels through using ICG intensity diagram showed different patterns according to size of the AVM. ICG videoangiography showed good performance in evaluating flow dynamics of the AVM in patients undergoing surgery.
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spelling doaj-art-486afc50d8de4c75800af02ffbb0e2072025-08-20T02:38:01ZengWileyStroke Research and Treatment2090-81052042-00562019-01-01201910.1155/2019/72923047292304Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green VideoangiographyNaoki Kato0Vincent Prinz1Julius Dengler2Peter Vajkoczy3Department of Neurosurgery, Charité Universitätsmedizin Berlin, GermanyDepartment of Neurosurgery, Charité Universitätsmedizin Berlin, GermanyDepartment of Neurosurgery, Charité Universitätsmedizin Berlin, GermanyDepartment of Neurosurgery, Charité Universitätsmedizin Berlin, GermanyIntraoperative indocyanine green (ICG) videoangiography is widely used in patients undergoing neurosurgery. FLOW800 is a recently developed analytical tool for ICG videoangiography to assess semi-quantitative flow dynamics; however, its efficacy is unknown. In this study, we evaluated its functionality in the assessment of flow dynamics of arteriovenous malformation (AVM) through ICG videoangiography under clinical settings. ICG videoangiography was performed in the exposed AVM in eight patients undergoing surgery. FLOW800 analysis was applied directly, and gray-scale and color-coded maps of the surgical field were obtained. After surgery, a region of interest was placed on the individual vessels to obtain time-intensity curves. Parameters of flow dynamics, including the maximum intensity, transit time, and cerebral blood flow index, were calculated using the curves. The color-coded maps provided high-resolution images; however, reconstruction of colored images was restricted by the depth, approach angle, and brain swelling. Semi-quantitative parameters were similar among the feeders, niduses, and drainers. However, a higher cerebral blood flow index was observed in the feeders of large AVM (>3 cm) than in those of small AVM (P < 0.05). Similarly, the cerebral blood flow index values were positively correlated with the nidus volume (P < 0.01). FLOW800 enabled visualization of the AVM structure and safer resection, except in case of deep-seated AVM. Moreover, semi-quantitative values in the individual vessels through using ICG intensity diagram showed different patterns according to size of the AVM. ICG videoangiography showed good performance in evaluating flow dynamics of the AVM in patients undergoing surgery.http://dx.doi.org/10.1155/2019/7292304
spellingShingle Naoki Kato
Vincent Prinz
Julius Dengler
Peter Vajkoczy
Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green Videoangiography
Stroke Research and Treatment
title Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green Videoangiography
title_full Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green Videoangiography
title_fullStr Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green Videoangiography
title_full_unstemmed Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green Videoangiography
title_short Blood Flow Assessment of Arteriovenous Malformations Using Intraoperative Indocyanine Green Videoangiography
title_sort blood flow assessment of arteriovenous malformations using intraoperative indocyanine green videoangiography
url http://dx.doi.org/10.1155/2019/7292304
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