title: Semiquantitative analysis of indocyanine green videoangiography for cortical perfusion assessment in superficial temporal artery to middle cerebral artery anastomosis.
abstract: BACKGROUND
  Postoperative hyperperfusion may lead to severe neurological complications after superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis. However, there are no reliable modalities to predict the occurrence of postoperative hyperperfusion during surgery. The purpose of this study is to evaluate whether a semiquantitative analysis of indocyanine green (ICG) videoangiography could be useful in predicting postoperative hyperperfusion after STA-MCA anastomosis.
  
  
  METHODS
  This study included seven patients who underwent STA-MCA anastomosis due to occlusive carotid artery diseases. During surgery, ICG videoangiography was performed before and after bypass procedures, and ICG intensity-time curves were semiquantitatively analyzed to evaluate hemodynamic changes by calculating maximum intensity, time to peak (TTP), and blood flow index (BFI).
  
  
  RESULTS
  Maximum intensity significantly increased from 252.6 ± 132.5 to 351.7 ± 151.9 after bypass (p < 0.001). TTP was significantly shortened from 12.9 ± 4.4 s to 9.8 ± 3.7 s (p < 0.001). Furthermore, BFI significantly increased from 33.9 ± 28.1 to 74.6 ± 88.4 (p < 0.05). Postoperative hyperperfusion was observed in five of seven patients 1 day after surgery. The ratio of BFI before and after bypass procedures was significantly higher in patients with postoperative hyperperfusion than those without, 2.5 ± 1.1 and 1.5 ± 0.4, respectively (p = 0.013).
  
  
  CONCLUSIONS
  These findings suggest that semiquantitative analysis of ICG videoangiography is helpful in predicting occurrence of hyperperfusion after STA-MCA anastomosis in patients with occlusive carotid artery diseases.
authors.affiliation: Sapporo Asabu Neurosurgical Hospital, North 40 East 1, Higashi-ku, Sapporo, Hokkaido, 007-0840, Japan. uchinoh@hotmail.co.jp
authors.forename: Haruto
authors.initials: H
authors.lastname: Uchino
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Nakamura
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Murata
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Saito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuroda
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D002548:Cerebral Revascularization / Q000379:methods; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D010477:Perfusion; D011859:Radiography; D013699:Temporal Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D020535:Video-Assisted Surgery
chemical_list: D007208:Indocyanine Green