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Role of Indocyanine Green Videoangiography in Identification of Donor and Recipient Arteries in Cerebral Bypass Surgery


Esposito, Giuseppe; Dias, Sandra; Burkhardt, Jan-Karl; Bozinov, Oliver; Regli, Luca (2018). Role of Indocyanine Green Videoangiography in Identification of Donor and Recipient Arteries in Cerebral Bypass Surgery. In: Esposito, Giuseppe; Regli, Luca; Kaku, Yasuhiko; Tsukahara, Tetsuya. Trends in the Management of Cerebrovascular Diseases. Cham: Springer, 85-89.

Abstract

The identification and preparation of a very good quality donor artery is a crucial step in every superficial temporal artery to middle cerebral artery (STA-MCA) bypass.For flow-preservation bypass performed for trapping of complex MCA aneurysms, the key element is the correct target of the recipient artery. When a cortical recipient artery (M4 segment of the MCA) is selected, this vessel must be a terminal branch of the artery whose sacrifice is necessary for definitive aneurysmal treatment.In this chapter we report on two techniques for (1) intraoperative mapping and preparation of good quality STA branch as the donor artery for STA-MCA bypass (mostly in the case the frontal branch of the STA needs to be used) and (2) selective identification of the correct superficial (M4 cortical) "recipient" artery in flow-preservation STA-MCA bypass performed for managing complex MCA aneurysms.Both techniques are based on the use of microscope-integrated indocyanine green videoangiography (ICG-VA), an intraoperative tool allowing observation and real-time assessment of blood flow in large and small vessels, with distinct evaluation of arterial, capillary, and venous phases.The two techniques contribute, respectively, to (1) reduce the risk of erroneous identification or injury of the donor artery in STA-MCA bypass procedures and (2) eliminate the risk of erroneous revascularization of a non-involved arterial territory in flow-preservation bypass surgery for managing complex MCA aneurysms.

Abstract

The identification and preparation of a very good quality donor artery is a crucial step in every superficial temporal artery to middle cerebral artery (STA-MCA) bypass.For flow-preservation bypass performed for trapping of complex MCA aneurysms, the key element is the correct target of the recipient artery. When a cortical recipient artery (M4 segment of the MCA) is selected, this vessel must be a terminal branch of the artery whose sacrifice is necessary for definitive aneurysmal treatment.In this chapter we report on two techniques for (1) intraoperative mapping and preparation of good quality STA branch as the donor artery for STA-MCA bypass (mostly in the case the frontal branch of the STA needs to be used) and (2) selective identification of the correct superficial (M4 cortical) "recipient" artery in flow-preservation STA-MCA bypass performed for managing complex MCA aneurysms.Both techniques are based on the use of microscope-integrated indocyanine green videoangiography (ICG-VA), an intraoperative tool allowing observation and real-time assessment of blood flow in large and small vessels, with distinct evaluation of arterial, capillary, and venous phases.The two techniques contribute, respectively, to (1) reduce the risk of erroneous identification or injury of the donor artery in STA-MCA bypass procedures and (2) eliminate the risk of erroneous revascularization of a non-involved arterial territory in flow-preservation bypass surgery for managing complex MCA aneurysms.

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Additional indexing

Item Type:Book Section, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:cerebral bypass; donor artery; extra-intracranial bypass; flow-preservation bypass; Indocyanine green videoangiography - ICGVA; neurosurgery; recipient artery; selective revascularization
Language:English
Date:2018
Deposited On:21 Sep 2018 12:58
Last Modified:07 May 2019 11:50
Publisher:Springer
Series Name:Acta Neurochirurgica. Supplementum
Number:129
ISSN:0065-1419
ISBN:978-3-319-73738-6
Additional Information:Online ISBN 978-3-319-73739-3
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/978-3-319-73739-3_12
PubMed ID:30171318

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