title: The feasibility of detecting cerebral blood flow direction using the indocyanine green video angiography.
abstract: The intraoperative confirmation of blood flow direction is necessary in cerebral vascular surgery. Using indocyanine green video angiography (ICG-VAG) with the FLOW 800 system, we examined the transit time of the blood vessel of interest and semiquantitatively evaluated the delay time (T1/2max) from indocyanine green (ICG) injection into the donor artery in reconstructive surgery and the middle cerebral artery (MCA) in aneurysmal surgery. The direction of cerebral blood flow (CBF), which can often be confirmed by ICG-VAG, may be more difficult to determine with faster blood flow. Here, we report our findings regarding the feasibility of detecting CBF direction using the FLOW 800 system. Twenty patients undergoing superficial temporal artery (STA) to MCA anastomosis for carotid occlusive disease and 13 patients with a small MCA aneurysm clipping were evaluated using the T1/2max, semiquantitative method with the FLOW 800 system. In STA-MCA anastomosis cases, the regions of interest (ROIs) included: the proximal donor STA and a region more than 10 mm on the distal side of the donor STA near the anastomosis site. In MCA aneurysms, the ROIs included the proximal M1 and distal M2 sides of the MCA aneurysm. T1/2max was significantly shorter for the proximal sites compared to the distal sites for all subjects (ps < 0.01). T1/2max was shorter for all subjects in the proximal sites. The direction of CBF can be determined using the FLOW 800 system.
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-86, Japan. ymurai@nms.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Murai
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-86, Japan.
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Nakagawa
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-86, Japan.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Matano
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-86, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Shirokane
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-86, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Teramoto
authors.affiliation: Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-86, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Morita
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography / Q000379:methods; D002548:Cerebral Revascularization / Q000379:methods; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*; D013699:Temporal Arteries / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: Anastomosis; Cerebral aneurysm; Flow direction; Indocyanine green; Patency