Division of Neurological Surgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
Neurosurgery. 2010 Aug;67(2):471-5. doi: 10.1227/01.NEU.0000372205.53792.E4.
We introduce a technique that enables the use of catheter angiography during image-guided surgery for the resection of previously embolized arteriovenous malformations.
We used models to test the possibility of matching specific anatomic points 1:1 and the accuracy of merging catheter-based 3-dimensional angiography with standard computed tomographic angiography.
After obtaining excellent accuracy matching the 2 modalities, we merged both studies into the image-guidance platform. After embolizing a patient's arteriovenous malformation with Onyx, we successfully used the merged study to navigate during surgical resection of the lesion. No complications resulted from this technique, which increases contrast by only 15 cm and radiation exposure by 4 seconds.
Catheter-based angiography can be used during image guidance to reduce the artifact from metal particles after embolization. Excellent accuracy was obtained in merging 3-dimensional angiography with computed tomographic angiography. Further studies are needed to evaluate catheter-based 3-dimensional angiography as a single method for navigation during neurovascular surgery.
我们介绍一种技术，使导管血管造影术能够用于引导手术切除先前栓塞的动静脉畸形。
我们使用模型来测试 1:1 匹配特定解剖点的可能性和将基于导管的 3 维血管造影术与标准计算机断层血管造影术融合的准确性。
在获得 2 种模式的精确匹配后，我们将这两项研究合并到图像引导平台中。在用 Onyx 栓塞患者的动静脉畸形后，我们成功地使用合并后的研究在手术切除病变时进行导航。该技术没有导致任何并发症，仅增加了 15 厘米的对比度和 4 秒的辐射暴露。
导管血管造影术可用于图像引导，以减少栓塞后金属颗粒的伪影。将 3 维血管造影术与计算机断层血管造影术融合获得了很好的准确性。需要进一步的研究来评估基于导管的 3 维血管造影术作为神经血管手术导航的单一方法。
