Contemporary tools in AVM surgery.

Contemporary tools in AVM surgery. J Neurosurg Sci. 2018 Mar 26;: Authors: Cenzato M, Dones F, Boeris D, Marcati E, Fratianni A, Crisà FM, Debernardi A Abstract Arteriovenous malformations (AVMs) are rare entities and therefore considered the main challenge for a neurosurgeon. Since the publication of the ARUBA study, one of the most popular debate regards the actual surgical indication for unruptured AVMs. Our group recently published a multicenter review of more than 500 cases underlying the important role of surgery. In the last decades, the expanding technologies used in the treatment of AVMs have shown an ongoing improvement overcoming some of the existing difficulties and shortcomings. In this paper, we reviewed the present literature to illustrate the main contemporary tools that, in our opinion, are crucial to obtain the best surgical and clinical outcome. Indocyanin green (ICG) is nowadays considered quite a gold standard to identify arterial feeders, draining veins, and to detect any eventual residual. The use of non-stick bipolar, 2-mm blade microclips, and thulium laser allows to obtain a better bleeding control and nidus removal. The development of the intraoperative ultrasound with neuronavigation, angiosonography, and color-Doppler improves the accuracy of AVM resection. Moreover, improvements have been developed with the use of intraoperative microdopplers combined with flow measurements, which consent to verify the ...
Source: Journal of Neurosurgical Sciences - Category: Neurosurgery Tags: J Neurosurg Sci Source Type: research