Abstract
BackgroundArteriovenous malformation(AVM) have long-term “blood stealing” characteristics, which result in complicated hemodynamic features. To analyze the application of intraoperative indocyanine green angiography with FLOW 800 software in AVM surgeries.MethodsData on 17 patients undergoing surgery with ICG fluorescence were collected in Beijing Tiantan Hospital. To analyze the hemodynamic features of AVM and the influence on the peripheral cortex of AVM resection, we assessed the following hemodynamic parameters: maximum intensity, slope of rise, time to half-maximal fluorescence, and transit time from arteries to veins.ResultsIn the 17 superficial AVMs studied, the time-delay color mode of the FLOW 800 software was superior to the traditional playback mode for identifying feeding arteries, draining veins, and their relation to normal cortical vessels. The maximum fluorescence intensity and slope of the ICG fluorescence curve of feeder arteries and draining veins were higher than those of normal peripheral vessels (P < 0.05). The transit times in AVMs were significantly shorter than those in normal peripheral vessels (P < 0.05). After AVM resection, cerebral flow increased in the cortex, and local cycle time becomes longer, although the differences were not significant (P > 0.05).ConclusionsHemodynamic parameter analysis provided quality guidance for the resection of AVMs and could also be used in estimating changes in blood flow in the local cortex to identify abnormal hyperperfusion and residual nidus.
Highlights
Arteriovenous malformation(AVM) have long-term “blood stealing” characteristics, which result in complicated hemodynamic features
Real-time vascular imaging and hemodynamic monitoring are necessary for surgical strategy adjustments during Arteriovenous malformations (AVMs) surgery
The time-delay color map provided by the software employs colors to instantly identify the direction and sequence of blood flow
Summary
Arteriovenous malformation(AVM) have long-term “blood stealing” characteristics, which result in complicated hemodynamic features. To analyze the application of intraoperative indocyanine green angiography with FLOW 800 software in AVM surgeries. Arteriovenous malformations (AVMs) are responsible for about 2% of all hemorrhagic strokes, mainly in children and young adults [1, 2]. Intraoperative indocyanine green (ICG) videoangiography is used widely in neurosurgery and has proven a useful addition to neurovascular surgery [3,4,5,6]. FLOW is a recently developed visualization, cinefluorography, and data analysis software that can be installed in the Carl Zeiss OPMI Pentero or OPMI Pentero 900 surgical microscopy system to analyze hemodynamic data. The time-delay color map provided by the software employs colors to instantly identify the direction and sequence of blood flow. The intensity diagram function helps to visualize variations in blood flow over time
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