Quantitative assessment of vessel flow integrity for aneurysm surgery. Technical note.
Quantitative measurement of blood flow in cerebral vessels during aneurysm surgery can help prevent ischemic injury and improve patient outcome. The authors report a case of a superior cerebellar artery (SCA) aneurysm in which perivascular microflow probes were used to measure blood flow quantitatively in both the SCA and the posterior cerebral artery before and after aneurysm clipping. Following aneurysm clipping, blood flow in the SCA was reduced to less than 25% of its initial baseline value. Prompt detection of compromised blood flow gave the surgeon the opportunity to adjust the clip and restore SCA flow to its preclipping value within 5 minutes of initial clip placement. Quantitative vessel-flow measurements were integral to the safe progression of the operation and may have prevented an adverse neurological outcome in this patient. The recommended surgical technique and the principle of operation are described.
Charbel
F T
FT
Department of Neurosurgery, University of Illinois at Chicago, 60612, USA. fcharbel@uic.edu
Gonzales-Portillo
G
G
Hoffman
W E
WE
Ostergren
L A
LA
Misra
M
M
D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology*; D002545:Brain Ischemia / Q000503:physiopathology / Q000517:prevention & control; D002531:Cerebellum / Q000098:blood supply; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000503:physiopathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000503:physiopathology / Q000517:prevention & control; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation*; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D020769:Posterior Cerebral Artery / Q000503:physiopathology; D013525:Surgical Instruments