gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Intra-operative indocyaninegreen (ICG)-fluorescence derived quantification of cerebral perfusion during cerebral bypass surgery

Meeting Abstract

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  • M.A. Kamp - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • N. Etminan - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • H.J. Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • D. Hänggi - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.15.09

doi: 10.3205/12dgnc141, urn:nbn:de:0183-12dgnc1414

Published: June 4, 2012

© 2012 Kamp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The aim of our study was to evaluate intra-operative changes of cortical perfusion during cerebral revascularization surgery estimated by quantification of ICG-derived fluorescence.

Methods: ICG perfusion measurements where investigated in patients treated for cerebral stenoocclusive disease and Moya Moya syndrome during application of a standard superficial temporal artery to middle cerebral artery bypass (EC-/IC-) bypass. Cortical ICG fluorescence was quantified after application of a 5 mg bolus ICG in defined regions of interest (ROI) using the microscope integrated software "Flow800" (Zeiss Pentero; Carl Zeiss meditec, Oberkochen, Germany). Fluorescence intensity, rise time (RT, time between 10 and 90% of maximum fluorescence intensity), time to peak (TTP) and cerebral blood flow index (cBFI) were calculated before and after bypass surgery.

Results: In a series of 10 patients (each 5 for occlusive and Moya Moya desease) a total of 20 ICG measurements were performed. Mean age was 45 y (17–61 y). Before revascularization, overall maximum fluorescence intensity was 451.6 arbitrary intensity units, mean RT (4.1–12.1 s, SD: 2.5 s), mean TTP 10.9 s (8.4–20.4 s, SD: 4,4 s). Despite successful revascularization as evaluated by postoperative angiography, overall fluorescence parameters and CT-based perfusion parameters did not significantly change after surgery. We found no statistically significant correlation between perioperative course of ICG-derived fluorescence parameters and CT-based brain perfusion measurement.

Conclusions: Although quantification of ICG-derived fluorescence may be a promising approach for an intra-operative estimation of cerebral perfusion, we found no significant changes of ICG-derived fluorescence parameters before and after application of the bypass grafts and no correlation to CT-based perfusion measurements. Therefore, quantification of ICG-derived fluorescence seems to give no additional information during application of EC-/IC-bypass grafts.