Artikel
3D-rotational angiography image guidance for aneurysm surgery
3D-Rotationsangiographie-gestützte vaskuläre Neuronavigation in der Chirurgie intrakranieller Aneurysmen
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Autoren
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Andreas Raabe
- Neurosurgical Department, Johann-Wolfgang-Goethe-University, Frankfurt/Main
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V. Seifert
- Neurosurgical Department, Johann-Wolfgang-Goethe-University, Frankfurt/Main
| Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
We report about the integration of 3D rotational angiography (3D-RA) data in a surgical navigation system by a newly developed perspectival registration technique and the intraoperative use in aneurysm surgery.
Methods
All patients underwent 3D-RA (Philips Integris, Philips Medical Systems, Eindhoven) for diagnosis of intracranial aneurysm and to decide about the treatment modality. During angiography, head position was recorded by a special localisation system. 3D-data were exported as VRML-files and loaded into the navigational system (VectorVision2, BrainLAB, Heimstetten). Intraoperatively, perspectival navigation was performed and microscope navigation was used to minimize the dissection of the aneurysm neck and the branching arteries.
Results
A total of 20 aneurysms were clipped with 3D-RA image guidance. Intraoperatively, the vascular configuration and spatial relationshipas shown by the 3D-RA based navigation corresponded excellent with the intraoperative anatomy. In 9 cases, 3D-RA helped to minimize the dissection by predicting the location of the aneurysm or the parent and branching arteries that were covered by brain tissue or blood clots.
Conclusions
Image guidance by high quality 3D-rotational angiography may help to exactly localize the position of the aneurysm and the related parent and branching vessels. It may help to focus the dissection, to minimize exposure and to reduce intraoperative complications in aneurysm surgery.
