Department of Neurosurgery, Banner University Medical Center, University of Arizona, Tucson, AZ, USA.
Department of Medicine and Nutrition, University of Guanajuato, Leon, Mexico.
Neurosurg Rev. 2022 Jun;45(3):1951-1964. doi: 10.1007/s10143-022-01733-3. Epub 2022 Feb 11.
Augmented reality (AR) is an adjuvant tool in neuronavigation to improve spatial and anatomic understanding. The present review aims to describe the current status of intraoperative AR for the treatment of cerebrovascular pathology. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following databases were searched: PubMed, Science Direct, Web of Science, and EMBASE up to December, 2020. The search strategy consisted of "augmented reality," "AR," "cerebrovascular," "navigation," "neurovascular," "neurosurgery," and "endovascular" in both AND and OR combinations. Studies included were original research articles with intraoperative application. The manuscripts were thoroughly examined for study design, outcomes, and results. Sixteen studies were identified describing the use of intraoperative AR in the treatment of cerebrovascular pathology. A total of 172 patients were treated for 190 cerebrovascular lesions using intraoperative AR. The most common treated pathology was intracranial aneurysms. Most studies were cases and there was only a case-control study. A head-up display system in the microscope was the most common AR display. AR was found to be useful for tailoring the craniotomy, dura opening, and proper identification of donor and recipient vessels in vascular bypass. Most AR systems were unable to account for tissue deformation. This systematic review suggests that intraoperative AR is becoming a promising and feasible adjunct in the treatment of cerebrovascular pathology. It has been found to be a useful tool in the preoperative planning and intraoperative guidance. However, its clinical benefits remain to be seen.
增强现实(AR)是神经导航的辅助工具,可提高空间和解剖理解。本综述旨在描述用于治疗脑血管病的术中 AR 的现状。根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行了系统评价。搜索了以下数据库:PubMed、Science Direct、Web of Science 和 EMBASE,截至 2020 年 12 月。搜索策略包括“增强现实”、“AR”、“脑血管”、“导航”、“神经血管”、“神经外科”和“血管内”的 AND 和 OR 组合。包括的研究是具有术中应用的原始研究文章。彻底检查了手稿的研究设计、结果和结果。确定了 16 项研究,描述了术中 AR 在治疗脑血管病中的应用。共 172 例患者因 190 例脑血管病变接受了术中 AR 治疗。最常见的治疗病理是颅内动脉瘤。大多数研究都是病例研究,只有一项病例对照研究。显微镜中的抬头显示器系统是最常见的 AR 显示器。AR 被发现可用于定制颅骨切开术、硬脑膜切开术以及在血管旁路中正确识别供体和受体血管。大多数 AR 系统无法解释组织变形。这项系统评价表明,术中 AR 正在成为治疗脑血管病的一种有前途且可行的辅助手段。它已被证明是术前计划和术中指导的有用工具。然而,其临床益处仍有待观察。
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