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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(01): 26-30
DOI: 10.4103/ajns.AJNS_342_19
Original Article

Intraoperative use of microscope-integrated flow 800 – A valuable tool in surgical management of anterior communicating artery aneurysm: Our institutional experience

Vaibhav Chavan
1   Department of Neurosurgery, Krishna Institute of Medical Sciences, Karad, Maharashtra
,
Yashuhiro Yamada
2   Department of Neurosurgery, Fujita Health University, Babuntane Hospital, Nagoya
,
Kadam Chandratej
2   Department of Neurosurgery, Fujita Health University, Babuntane Hospital, Nagoya
,
Devareddy Gowtham
2   Department of Neurosurgery, Fujita Health University, Babuntane Hospital, Nagoya
,
Stanzani Riccardo
3   Department of Neurosurgery, Neurosurgery Unit AOU Policlinico di Modena – OCSAE Modena Hospital, Modena, Italy
4   Neurosurgical Residency Program of the University of Padova, Cerebrovascular and Skull Base Fellow at Fujita Healt University Bantane Hospital, Nagoya, Japan
,
Shukurov Firuz
2   Department of Neurosurgery, Fujita Health University, Babuntane Hospital, Nagoya
,
Kato Yoko
2   Department of Neurosurgery, Fujita Health University, Babuntane Hospital, Nagoya
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Background: Flow 800 is microscope-integrated analytical visualization tool which analyses the indocyanine green (ICG) video sequence and converts it into an intensity diagram. This allows an objective evaluation of the result rather than subjective assessment of ICG fluorescence. The anatomy of anterior communicating artery region is complex because of multiple vessels and perforators in small space; hence, there is a need of objective assessment tool which can give precise idea about vascular compromise. Flow 800 can serve as a valuable tool in this complex surgery. Objective: The objective of this study was to evaluate the utility of microscope-integrated fluorescent ICG videoangiography (Flow 800) in A-com aneurysm surgery. Materials and Methods: We used Flow 800 in ten consecutive patients of A-com aneurysm surgery from July 2019 to October 2019. We studied patient characteristics, intraoperative observation of ICG and Flow 800, and corresponding changes made in the operative decisions. Results: The use of Flow 800 helped in intraoperative decision of four out of ten patients of A-com aneurysm. In two patients, incomplete clipping was confirmed with Flow 800 and the second clip was applied. In the third patient, perforator compromise was found hence needed clip readjustment, whereas in the fourth patient, ICG was inconclusive and Flow 800 confirmed complete clipping of aneurysm. Conclusion: Flow 800 is a conclusive reproducible and objective tool for early detection of vascular compromise of multiple vessels and perforators in A-com aneurysm surgery. It gives a better idea of vasculature, especially where ICG is ambiguous or inconclusive.

Key-words:

A-com aneurysm surgery - Flow 800 - indocyanine green

Financial support and sponsorship

Nil.




Publication History

Received: 21 November 2019

Accepted: 10 January 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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