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首页> 外文期刊>Neurosurgical focus >A prospective study of microscope-integrated intraoperative fluorescein videoangiography during arteriovenous malformation surgery: Preliminary results
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A prospective study of microscope-integrated intraoperative fluorescein videoangiography during arteriovenous malformation surgery: Preliminary results

机译：动静脉畸形手术中显微镜集成术中荧光素视频血管造影的前瞻性研究：初步结果

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Object: The authors report on the use of a recently developed microscope-integrated fluorescent module using low-dose intravenous fluorescein for videoangiography during arteriovenous malformation (AVM) surgery. Methods: The authors analyzed the application of a low-dose intraoperative fluorescein in 4 consecutive patients undergoing AVM surgery. The ability to distinguish the associated vessels of the AVM from normal vessels and to assess the degree of AVM obliteration based on videoangiography of venous drainage was specifically analyzed. Results: All 4 patients underwent fluorescein angiography without complication. In each case, videoangiography confirmed recognition of feeding arteries and draining veins through the operating oculars under the fluorescent mode. In one case involving a large frontal AVM, videoangiography demonstrated mainly cortical veins on the surface of the AVM and alerted the senior author to first tackle the feeding arteries in the interhemispheric space. While evaluating the flow within the different draining veins after most of the AVM was disconnected, videoangiography also prioritized the order for disconnection of large draining veins to allow mobilization the AVM and exposure of the remaining deep arterial feeders. In the other 3 cases, videoangiography allowed easy recognition of the angioarchitecture of the AVMs, estimated its cortical boundaries, and most importantly, assessed the flow within the draining veins before their disconnection. Conclusions: The authors found fluorescein videoangiography to be a useful adjunct in resection of AVMs. This technology offers the unique ability to visualize fluorescent vessels and nonfluorescent tissues in near-natural colors simultaneously and permits microsurgical manipulation of relevant structures under the fluorescent mode. Largerscale studies are needed to establish its efficacy and wider applicability.
机译：目的：作者报告了在动静脉畸形（AVM）手术期间使用低剂量静脉内荧光素的最近开发的显微镜集成荧光模块在视频血管造影中的应用。方法：作者分析了低剂量术中荧光素在连续4例接受AVM手术的患者中的应用。具体分析了将AVM的相关血管与正常血管区分开并根据静脉引流的血管造影评估AVM闭塞程度的能力。结果：全部4例患者均接受了荧光素血管造影检查，无并发症。在每种情况下，视频血管造影都可以确认在荧光模式下通过手术眼对进食动脉和引流静脉的识别。在一个涉及大额额AVM的案例中，视频血管造影显示AVM表面主要是皮质静脉，并提醒资深作者首先处理半球间空间的饲喂动脉。在大多数AVM断开连接后，在评估不同引流静脉内的血流时，视频血管造影还对断开大引流静脉的顺序进行了优先排序，以允许AVM动员并暴露其余深层动脉供体。在其他3种情况下，视频血管造影可以轻松识别AVM的血管结构，估计其皮质边界，最重要的是，可以在引流静脉断开之前评估其流量。结论：作者发现荧光素视频血管造影是切除AVM的有用辅助手段。这项技术提供了独特的功能，可以同时以近自然的颜色可视化荧光血管和非荧光组织，并允许在荧光模式下对相关结构进行显微外科操作。需要进行大规模研究来确定其功效和更广泛的适用性。

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