Artikel
Intraoperative B-mode and power duplex sonography in aneurysm surgery: Comparison to pre- and postoperative digital subtraction angiography
Intraoperative B-mode und Power-Duplex-Sonographie in der Aneurysmachirurgie: Der Vergleich zur prä- und postoperativen digitalen Subtraktionsangiographie
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Autoren
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D. Hänggi
- Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
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B. Turowski
- Radiologische Klinik, Abteilung für Neuroradiologie, Heinrich-Heine-Universität, Düsseldorf
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H.-J. Steiger
- Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
| Veröffentlicht: | 11. April 2007 |
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Gliederung
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Objective: The purpose of this study was to evaluate the efficacy and reliability of combined intra-operative B-mode and power duplex sonography in aneurysm surgery. To analyse this question, the results of intraoperative sonography were compared with digital subtraction angiography (DSA) as the gold standard.
Methods: 40 patients who underwent surgery for 44 intracranial aneurysms were included in this study. Intraoperative sonographic examination following craniotomy and aneurysm clipping was carried out using a Siemens Elegra unit equipped with a 2.5-MHz probe. Obliteration of aneurysms and patency of the major arteries around the clipped aneurysm were looked at as intraoperative key parameters. The results of sonography where compared with the pre- and postoperative DSA.
Results: Demonstration of the base of the clipped aneurysm by duplex sonography was possible and satisfactory in 38 (86.3%) aneurysms. In six cases, the illustration of the aneurysm base was not possible due to multiple clips for example for example. All of these 38 satisfactory results showed conformity with the postoperative DSA. 127 of a total of 135 preoperatively defined major vessels were clearly identified and analysed intraoperatively by using power duplex sonography (94%).The comparison with postoperative DSA showed a concordance in 98.4%, corresponding to a total of 125 major related cerebral arteries on postoperative DSA. Clip repositioning because of intraoperative B-mode and duplex measurement was performed in two cases. Intra-operative sonography caused no probe-related complications.
Conclusions: In comparison to postoperative DSA, intraoperative combined B-mode and power duplex sonography in aneurysm surgery offers an immediate, reliable and non-invasive documentation of the occlusion quality of cerebral aneurysms after clipping. In addition, this technique permits the immediate evaluation of blood flow in the major arterial branches around the aneurysm.
