title: Efficacy of FLOW 800 with indocyanine green videoangiography for the quantitative assessment of flow dynamics in cerebral arteriovenous malformation surgery.
abstract: OBJECTIVE
  To evaluate the quantitative assessment of flow dynamics during surgery for arteriovenous malformations (AVMs) with FLOW 800 with indocyanine green videoangiography.
  
  
  METHODS
  Changes in flow dynamics in the superficial AVM components (feeder, nidus, and drainer), the adjacent cortical artery, and the cortical vein surrounding AVM were evaluated. Analysis was performed at predissection, postclipping of the feeders, and postresection of the nidus with the use of quantitative values of the maximum fluorescence intensity, time to half-maximum fluorescence intensity (T1/2 FI), and the fluorescence intensity rate at T1/2 FI semiautomatically obtained with the use of FLOW 800 software.
  
  
  RESULTS
  FLOW 800 assessments were performed in 7 cases. The time difference between the T1/2 FI, defined as transit time, in the cortical artery and the drainer was prolonged from 0.08 ± 0.65 seconds to 2.63 ± 1.79 seconds (P < 0.0001) at postfeeder clipping phase. The transit time between the cortical artery and the cortical vein was reduced to 3.76 ± 1.37 seconds at post feeder clipping phase (P = 0.024) and 2.63 ± 0.80 seconds at final phase (P = 0.005) compared with 4.56 ± 1.47 seconds at predissection phase. The maximum intensity and the fluorescence intensity rate at T1/2 FI were not significantly different at these phases, excluding the maximum intensity of the drainer decreasing from 533 ± 271 to 399 ± 217 (P = 0.006) at post feeder clipping phase.
  
  
  CONCLUSIONS
  FLOW 800 analysis with indocyanine green videoangiography provides the real-time hemodynamic status of the AVMs and adjacent brain at various stages of resection. This technique is feasible to resect AVMs more safely and convincingly.
authors.affiliation: Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Kataoka
authors.affiliation: Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Nakajima
authors.affiliation: Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Masuoka
authors.affiliation: Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Satow
authors.affiliation: Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: kiihara@ns.med.kyushu-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Iihara
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D002533:Cerebral Angiography / Q000379:methods*; D002560:Cerebrovascular Circulation; D002648:Child; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D007208:Indocyanine Green; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000601:surgery; D012984:Software; D014741:Video Recording
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: Arteriovenous malformation; FLOW 800; Indocyanine green videoangiography; Quantitative assessment