Cortical Perfusion Measurement by Indocyanine-Green Videoangiography in Patients Undergoing Hemicraniectomy for Malignant Stroke

Woitzik, Johannes; Peña-Tapia, Pablo; Schneider, Ulf C.; Vajkoczy, Peter; Thomé, Claudius

doi:10.1161/01.str.0000221671.94521.51

Cited by 74 publications

(41 citation statements)

References 11 publications

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“…This device was successfully applied in studies related to monitoring of focal changes in brain cor− tex oxygenation during motor stimulation. The instrument allows also for evaluation of optical contrast agent inflow and washout which can be used in estimation of brain perfu− sion parameters [33,[79][80][81]. In series of experiments on phantoms and in healthy volunteers we showed feasibility of time resolved measurements in diffuse reflectance mode and fluorescence light detection.…”

Section: Discussionmentioning

confidence: 92%

Time-resolved multi-channel optical system for assessment of brain oxygenation and perfusion by monitoring of diffuse reflectance and fluorescence

Milej

Gerega

Kacprzak

et al. 2014

Opto-Electronics Review

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Time-resolved near-infrared spectroscopy is an optical technique which can be applied in tissue oxygenation assessment. In the last decade this method is extensively tested as a potential clinical tool for noninvasive human brain function monitoring and imaging. In the present paper we show construction of an instrument which allows for: (i) estimation of changes in brain tissue oxygenation using two-wavelength spectroscopy approach and (ii) brain perfusion assessment with the use of single-wavelength reflectometry or fluorescence measurements combined with ICG-bolus tracking. A signal processing algorithm based on statistical moments of measured distributions of times of flight of photons is implemented. This data analysis method allows for separation of signals originating from extra- and intracerebral tissue compartments. In this paper we present compact and easily reconfigurable system which can be applied in different types of time-resolved experiments: two-wavelength measurements at 687 and 832 nm, single wavelength reflectance measurements at 760 nm (which is at maximum of ICG absorption spectrum) or fluorescence measurements with excitation at 760 nm. Details of the instrument construction and results of its technical tests are shown. Furthermore, results of in-vivo measurements obtained for various modes of operation of the system are presented.

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Section: Discussionmentioning

confidence: 92%

Time-resolved multi-channel optical system for assessment of brain oxygenation and perfusion by monitoring of diffuse reflectance and fluorescence

Milej

Gerega

Kacprzak

et al. 2014

Opto-Electronics Review

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“…While DS angiography remains the gold standard, 4,10,23,29 it is invasive and associated with high financial and personal costs. Alternatively, the noninvasive visualization of brain vasculature through indocyanine green videoangiography 22,27,28 permits inexpensive, highquality imaging of the cortical vasculature. However, both techniques fail to measure relative CBF instantaneously, and the systemic administration of a contrast agent may limit technical repeatability.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,22,27,28 While indocyanine green videoangiography or intraoperative DS angiography can be applied to evaluate vascular patency during bypass 27,29 or aneurysm 10,22 surgery, these procedures fail to visualize relative microcirculatory flow or tissue perfusion. Potential neurovascular indications for which a direct or indirect assessment of tissue perfusion can become critical are as follows: identification of clip-related vessel stenosis or occlusion, assessment of bypass patency, or confirmation of adequate flow replacement following revascularization for parent vessel sacrifice (hunterian ligation).…”

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confidence: 99%

Intraoperative monitoring of cerebral blood flow by laser speckle contrast analysis

Hecht

Woitzik²,

Dreier

et al. 2009

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109

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Object Currently, reliable low-cost and noninvasive techniques to assess cerebral perfusion in the operating room are not available. The authors report on their first clinical experience with laser speckle contrast analysis (LASCA) as a complementary imaging tool for the noninvasive and dynamic assessment of cerebral blood flow (CBF) during neurovascular surgery. The purpose of this preliminary study was to address the general feasibility of LASCA in terms of handling and image quality and to provide an example of its clinical implications. Methods Laser speckle contrast analysis was performed in patients undergoing cerebral revascularization procedures for the treatment of hemodynamic compromise and complex aneurysms. The portable LASCA device was centered over the surgical field, and continuous 5-minute recordings of relative CBF were obtained. In the case of flow augmentation for hemodynamic compromise, CBF monitoring was performed before and after completion of the anastomosis. In the case of flow replacement for parent artery sacrifice, CBF monitoring was performed during consecutive 30-second test occlusions of the radial artery graft after proximal internal carotid artery sacrifice and the subsequent initiation of blood flow through the bypass. Results In all cases, the authors achieved good visualization of relative CBF in addition to flow imaging in both the bypass graft and the cortical vasculature. During a sudden CBF decrease after test occlusion of the radial artery graft and subsequent flow initiation through the bypass, LASCA allowed immediate visualization and measurement of relative CBF in excellent spatiotemporal resolution. Conclusions In this study LASCA offered noninvasive and rapid intraoperative assessment of relative CBF, which can be used for optimizing neurovascular procedures.

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“…For patients undergoing decompressivecraniectomy, ICG -VA allowed to evaluate the superficial vascular anatomy and leptomeningeal anastomosis patency [67]. It appears to be a valuable tool to precisely detect relative cortical tissue perfusion, providing useful research data on the pathophysiology of human stroke, helping surgeons to maintain adequate brain perfusion intraoperatively, and simplify adequate placement of tissue probes to monitor critically hypoperfused brain tissue.…”

Section: Other Applicationsmentioning

confidence: 99%

Indocyanine green video-angiography in neurosurgery: A glance beyond vascular applications

Scerrati¹,

Pepa²,

Conforti³

et al. 2014

Clinical Neurology and Neurosurgery

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OBJECTIVE: Indocyanine green video angiography (ICG-VA) is a non invasive, easy to use and a very useful tool for various neurosurgical procedures. Initially introduced in vascular neurosurgery since 2003, it's applications have broadened over time, both in vascular applications and in other neurosurgical fields. The objective of our study is to review all published literature about ICG-VA, cataloguing its different applications. METHODS: A systematic review of all pertinent literature articles published from January 2003 to May 2014 using Pubmed access was performed using pertinent keywords; cross check of references of selected articles was performed in order to complete bibliographical research. Results of research were grouped by pathology. RESULTS AND CONCLUSIONS: The paper systematically analyses ICG-VA different applications in neurosurgery, from vascular neurosurgery to tumor resection and endoscopic applications, focusing on reported advantages and disadvantages, and discussing future perspectives. Disclosure statement: the authors declare no interest to disclose, they have any personal or institutional financial interest in drugs, materials, or devices described in this submission and that they did not receive any specific funding. The paper and any of its contents have been presented DOI Methods:A systematic review of all pertinent literature articles published from January 2003 to May 2014 using Pubmed access was performed using pertinent keywords; cross check of references of selected articles was performed in order to complete bibliographical research. Results of research were grouped by pathology. Results and ConclusionsThe paper systematically analyses ICG-VA different applications in neurosurgery, from vascular neurosurgery to tumour resection and endoscopic applications, focusing on reported advantages and disadvantages, and discussing future perspectives.

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Cortical Perfusion Measurement by Indocyanine-Green Videoangiography in Patients Undergoing Hemicraniectomy for Malignant Stroke

Cited by 74 publications

References 11 publications

Time-resolved multi-channel optical system for assessment of brain oxygenation and perfusion by monitoring of diffuse reflectance and fluorescence

Time-resolved multi-channel optical system for assessment of brain oxygenation and perfusion by monitoring of diffuse reflectance and fluorescence

Intraoperative monitoring of cerebral blood flow by laser speckle contrast analysis

Indocyanine green video-angiography in neurosurgery: A glance beyond vascular applications

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