Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA.
Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
J Neurointerv Surg. 2022 May;14(5):522-6. doi: 10.1136/neurintsurg-2021-017903. Epub 2021 Oct 11.
Evidence is growing to support minimally invasive surgical evacuation of intraparenchymal hematomas, particularly those with minimal residual hematoma volumes following evacuation. To maximize the potential for neurologic recovery, it is imperative that the trajectory for access to the hematoma minimizes disruption of normal parenchyma. Flat panel detector CT-based navigation and needle guidance software provides a platform that uses flat panel detector CT imaging obtained on the angiography table to aid reliable and safe access to the hematoma. In addition to providing a high degree of accuracy, this method also allows convenient and rapid re-imaging to assess navigation accuracy and the degree of hematoma evacuation prior to procedural completion. We provide a practical review of the iGuide needle guidance software and the methodology for incorporating its use, and the software of other vendors, in a variety of minimally invasive methods for evacuation of intraparenchymal hematomas.
越来越多的证据支持采用微创方式清除脑实质血肿，尤其是那些在清除后残余血肿量较少的血肿。为了最大限度地提高神经功能恢复的可能性，至关重要的是，进入血肿的路径应将对正常实质的破坏降至最低。基于平板探测器 CT 的导航和针引导软件提供了一个平台，该平台使用在血管造影台上获得的平板探测器 CT 成像来辅助可靠和安全地进入血肿。除了提供高度的准确性外，这种方法还允许方便和快速的重新成像，以在手术完成前评估导航准确性和血肿清除程度。我们提供了对 iGuide 针引导软件的实用回顾，以及在各种微创清除脑实质血肿方法中纳入其使用的方法，以及其他供应商软件的方法。
