Shi Wei, Qiao Guangyu, Sun Zhenghui, Shang Aijia, Wu Chen, Xu Bainan
Department of Neurosurgery, People's Liberation Army General Hospital, 28 Fuxing Rd, Beijing 100853, China.
Department of Neurosurgery, People's Liberation Army General Hospital, 28 Fuxing Rd, Beijing 100853, China.
J Clin Neurosci. 2015 Jul;22(7):1155-9. doi: 10.1016/j.jocn.2015.01.024. Epub 2015 Apr 29.
We aimed to evaluate the efficacy of FLOW 800 (Carl Zeiss Meditec, Jena, Thuringia, Germany) with indocyanine green (ICG) videoangiography for the quantitative assessment of flow dynamics in spinal dural arteriovenous fistula (dAVF) surgeries. We prospectively enrolled nine patients with spinal dAVF diagnosed within the past year and performed FLOW 800 analyses using ICG videoangiography before and after surgical obliteration of the fistula. A color-coded map was semi-automatically generated by FLOW 800 and used for high-resolution visualization of the vasculature and instant interpretation of the dynamic flow changes. The FLOW 800-specific hemodynamic parameters were employed for real-time measurements of parenchymal perfusion alterations. Overall, 18 intraoperative FLOW 800 analyses using ICG videoangiography were performed in nine patients. The color-coded map aided the detection and complete obliteration of the fistulas in all patients and the results were verified by postoperative spinal digital subtraction angiography. The transit time parameter was significantly shorter in the preobliteration phase than in the postobliteration phase (p < 0.01), the rise time parameter exhibited the same pattern (p = 0.08) and maximum intensity and blood flow index were not significantly different between these phases. FLOW 800 with ICG videoangiography provided an intuitive and objective understanding of blood flow dynamics intraoperatively and enabled easy and confident identification and treatment of this pathology. The FLOW 800-specific hemodynamic analyses provided additional perfusion information that enabled real-time measurements of parenchymal perfusion alterations. FLOW 800 with ICG videoangiography is useful for intraoperative quantitative assessment of flow dynamics, facilitating safety and confidence in the treatment of spinal dAVF.
我们旨在评估采用吲哚菁绿（ICG）血管造影的FLOW 800（德国图林根州耶拿市卡尔·蔡司医疗技术公司）在脊髓硬脊膜动静脉瘘（dAVF）手术中对血流动力学进行定量评估的疗效。我们前瞻性纳入了9例在过去一年内被诊断为脊髓dAVF的患者，并在瘘管手术闭塞前后使用ICG血管造影进行FLOW 800分析。FLOW 800半自动生成了一个彩色编码图，用于高分辨率可视化脉管系统并即时解读动态血流变化。采用FLOW 800特定的血流动力学参数实时测量实质灌注改变。总体而言，对9例患者进行了18次术中使用ICG血管造影的FLOW 800分析。彩色编码图有助于在所有患者中检测并完全闭塞瘘管，术后脊髓数字减影血管造影证实了结果。闭塞前阶段的通过时间参数显著短于闭塞后阶段（p < 0.01），上升时间参数呈现相同模式（p = 0.08），这些阶段之间的最大强度和血流指数无显著差异。采用ICG血管造影的FLOW 800在术中提供了对血流动力学直观且客观的理解，并能轻松且确定地识别和治疗这种病变。FLOW 800特定的血流动力学分析提供了额外的灌注信息，能够实时测量实质灌注改变。采用ICG血管造影的FLOW 800有助于术中对血流动力学进行定量评估，提高脊髓dAVF治疗的安全性和信心。
