Assessment of ischemic risk following intracranial-to-intracranial and extracranial-to-intracranial bypass for complex aneurysms using intraoperative Indocyanine Green-based flow analysis

Publication date: Available online 29 June 2019Source: Journal of Clinical NeuroscienceAuthor(s): Robert C. Rennert, Ben A. Strickland, Kristine Ravina, Michael G. Brandel, Joshua Bakhsheshian, Vance Fredrickson, Joseph Carey, Jonathan J. RussinAbstractCerebral bypass is often needed for complex aneurysms requiring vessel sacrifice, yet intraoperative predictors of ischemic risk in bypass-dependent territories are limited. Indocyanine Green (ICG)-based flow analyses (ICG-BFAs; Flow 800, Carl Zeiss, Oberkochen, Germany) semi-quantitatively assess cortical perfusion, and in this work we determine the efficacy of ICG-BFA for assessing post-operative ischemic risk during cerebral bypass surgery for complex aneurysms. Retrospective clinical and pre/post-bypass intra-operative ICG-BFA data (delay and blood flow index [BFI]) on ten patients undergoing cerebral bypass for complex cerebral aneurysms requiring vessel sacrifice were collected from a single-institution prospective database and analyzed via non-parametric testing and logistic regression. Mean age was 55.9 ± 14.8 years. Pre/post-bypass delay (median 35.6 [5.1–51.3] vs. 26.0 [17.1–59.9]; p = 0.2) and BFI (median 56.1 [8.1–120.4] vs. 32.2 [3.0–147.4]; p = 0.2) did not significantly differ. Two patients (20%) developed post-operative ischemia in bypass dependent territories. Delay ratio did not differ between patients with and without post-operative ischemia (median 1.15 [0.67–1.64] vs. 0.83 [0.36–3...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research