Intraoperative biplanar rotational angiography during neurovascular surgery. Technical note.
OBJECTIVE
The purpose of this study was to evaluate the authors' initial experience with the integration of high-resolution rotational and biplanar angiography during neurovascular operative procedures.


METHODS
Eight patients with intracerebral arteriovenous malformations (AVMs) and aneurysms underwent surgical treatment of their lesions in a combined endovascular surgical suite. After initial head positioning, preoperative biplane and rotational angiography was performed. Resection of the AVM or clipping of the aneurysm was then performed. Further biplane and rotational 3D angiograms were obtained intraoperatively to confirm satisfactory treatment.


RESULTS
One small residual AVM identified intraoperatively necessitated further resection. One aneurysm was clipped during endovascular inflation of an intracarotid balloon for temporary proximal control. The completeness of treatment was confirmed on intraoperative 3D rotational angiography in all cases, and there were no procedure-related complications.


CONCLUSIONS
Intraoperative rotational angiography performed in an integrated biplane angiography/surgery suite is a safe and useful adjunct to surgery and may enable combining endovascular and surgical procedures for the treatment of complex vascular lesions.
Dehdashti
Amir R
AR
Division of Neurosurgery, Toronto Western Hospital, and University of Toronto, Toronto, Ontario, Canada.
Thines
Laurent
L
Da Costa
Leodante B
LB
terBrugge
Karel G
KG
Willinsky
Robert A
RA
Wallace
M Christopher
MC
Tymianski
Michael
M
D002533:Cerebral Angiography / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D009873:Operating Rooms; D055815:Young Adult