{"id":"447f6af0-b206-4041-94d8-5866cb33bea1","slug":"quantitative-cerebral-perfusion-assessment-using-microscope-integrated-analysis-of-intraoperative-indocyanine-green-fluorescence-angiography-versus-positron-emission-tomography-in-superficial-temporal","title":"Quantitative cerebral perfusion assessment using microscope-integrated analysis of intraoperative indocyanine green fluorescence angiography versus positron emission tomography in superficial temporal artery to middle cerebral artery anastomosis","authors":["Shinya Kobayashi","Tatsuya Ishikawa","Jun Tanabe","Junta Moroi","Akifumi Suzuki"],"abstract":"Background: Intraoperative qualitative indocyanine green (ICG) angiography has been used in cerebrovascular surgery. Hyperperfusion may lead to neurological complications after superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis. The purpose of this study is to quantitatively evaluate intraoperative cerebral perfusion using microscope-integrated dynamic ICG fluorescence analysis, and to assess whether this value predicts hyperperfusion syndrome (HPS) after STA-MCA anastomosis. Methods: Ten patients undergoing STA-MCA anastomosis due to unilateral major cerebral artery occlusive disease were included. Ten patients with normal cerebral perfusion served as controls. The ICG transit curve from six regions of interest (ROIs) on the cortex, corresponding to ROIs on positron emission tomography (PET) study, was recorded. Maximum intensity (IMAX), cerebral blood flow index (CBFi), rise time (RT), and time to peak (TTP) were evaluated. Results: RT/TTP, but not IMAX or CBFi, could differentiate between control and study subjects. RT/TTP correlated (|r| = 0.534-0.807; P P = 0.017). The ratio of TTP was also significantly lower in patients with postoperative HPS than in patients without postoperative HPS (0.64 ± 0.081 and 0.85 ± 0.095, respectively; P = 0.017). Conclusions: Time-dependent intraoperative parameters from the ICG transit curve provide quantitative information regarding cerebral circulation time with quality and utility comparable to information obtained by PET. These parameters may help predict the occurrence of postoperative HPS.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/447f6af0-b206-4041-94d8-5866cb33bea1/featured/hero-1782420983530.png","publishDate":"2014-09-15T00:00:00.000Z","doi":"10.4103/2152-7806.140705","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2015/05/4029/SNI-5-135.pdf"}