Intraoperative EC-IC Bypass Blood Flow Assessment With Indocyanine Green Angiography in Moyamoya and Non-Moyamoya Ischemic Stroke

OBJECTIVE The microvascular anatomy of spinal perimedullary arteriovenous fistulas (AVFs) is more complicated than that of dural AVFs, and occlusion rates of AVF after open microsurgery or endovascular embolization are lower in patients with perimedullary AVFs (29%–70%) than they are in those with dural AVF (97%–98%). Reports of intraoperative blood flow assessment using indocyanine green (ICG) video angiography in spinal arteriovenous lesions have mostly been for spinal dural AVFs. No detailed reports on spinal perimedullary AVFs are available. METHODS Participants were 11 patients with spinal perimedullary AVFs (Type IVa in 5 patients, Type VIb in 4, and Type IVc in 2). Intraoperative ICG video angiography was assessed by measuring the number of cases in which this modality was judged essential by the surgeon to correctly occlude the fistula. RESULTS In all patients, arterial feeders were identified and intravenous ICG video angiography was performed before and after blocking the feeders. In one patient, selective intraarterial ICG video angiography was also performed. The findings provided by ICG video angiography significantly changed the surgical procedure in 4 of 11 patients (36%). Postoperatively, complete occlusion of the AVF was achieved in 10 of the 11 patients (91%). CONCLUSIONS Intraoperative ICG video angiography can have a significant impact on deciding surgical strategy in the microsurgical treatment of spinal perimedullary AVF.

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Pulsation of anastomotic vortex veins in pachychoroid spectrum diseases

Scientific Reports ◽

10.1038/s41598-021-94412-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hidetaka Matsumoto ◽

Junki Hoshino ◽

Ryo Mukai ◽

Kosuke Nakamura ◽

Shoji Kishi ◽

...

Keyword(s):

Blood Flow ◽

Indocyanine Green ◽

Early Phase ◽

Indocyanine Green Angiography ◽

Case Series ◽

Pulsatile Blood Flow ◽

Retrospective Case ◽

Venous Flow ◽

Retrospective Case Series ◽

Vortex Vein

AbstractAccumulating evidence points to pachychoroid possibly being caused by vortex vein congestion which results in remodeling of choroidal drainage routes via intervortex vein anastomosis. This hypothesis prompted us to investigate vortex vein hemodynamics by studying videos of indocyanine green angiography (ICGA) in a retrospective case series of 295 eyes with pachychoroid spectrum diseases. In the early phase of the video-ICGA, pulsatile vortex venous flow was observed in 76 eyes (25.8%) at the vortex veins connected with anastomosis between superior and inferior vortex veins. The patients with pulsatile vortex venous flow were significantly older than those without pulsatile vortex venous flow (67.8 ± 13.2 vs. 63.9 ± 14.5 years, P < 0.05). Pulsatile vortex venous flow was 1.84 times more common in the inferior quadrants than in the superior quadrants. Interestingly, 14 of 76 eyes (18.4%) with pulsatile vortex venous flow showed retrograde pulsatile blood flow in the vortex veins. This retrograde pulsatile blood flow was 2.50 times more common in the inferior than in the superior quadrants. These findings indicate altered vortex vein hemodynamics due to vortex vein congestion in pachychoroid spectrum diseases.

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Laser speckle contrast imaging for visualizing blood flow during cerebral aneurysm surgery: A comparison with indocyanine green angiography

10.1101/2021.04.29.21254954 ◽

2021 ◽

Author(s):

David R. Miller ◽

Ramsey Ashour ◽

Colin T. Sullender ◽

Andrew K. Dunn

Keyword(s):

Blood Flow ◽

Indocyanine Green ◽

Real Time ◽

Indocyanine Green Angiography ◽

Laser Speckle ◽

Normal Operation ◽

Contrast Imaging ◽

Laser Speckle Contrast Imaging ◽

Speckle Contrast ◽

Aneurysm Clipping

AbstractLaser speckle contrast imaging (LSCI) has emerged as a promising tool for intraoperative cerebral blood flow (CBF) monitoring because it produces real-time full-field blood flow maps non-invasively and label-free. In this study, we compare LSCI with indocyanine green angiography (ICGA) to assess CBF during aneurysm clipping surgery in humans. LSCI hardware was attached to the surgical microscope prior to the start of each surgery and did not interfere with the sterile draping of the microscope or normal operation of the microscope. LSCI and ICGA were performed simultaneously to visualize CBF in n=4 aneurysm clipping cases, and LSCI was performed throughout each surgery when the microscope was positioned over the patient. To more easily visualize CBF in real-time, LSCI images were overlaid on the built-in microscope white light camera images and displayed to the neurosurgeon in real-time. Blood flow changes before, during, and after an aneurysm clipping were visualized with LSCI and later verified with ICGA. LSCI was performed continuously throughout the aneurysm clipping process, providing the surgeon with immediate actionable information on the success of the clipping. The results demonstrate that LSCI and ICGA provide different, yet complementary information about vessel perfusion.

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Possible connection of short posterior ciliary arteries to choroidal neovascularisations in eyes with pathologic myopia

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312015 ◽

2018 ◽

Vol 103 (4) ◽

pp. 457-462 ◽

Cited By ~ 9

Author(s):

Tomoka Ishida ◽

Takashi Watanabe ◽

Tae Yokoi ◽

Kosei Shinohara ◽

Kyoko Ohno-Matsui

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

Indocyanine Green ◽

Indocyanine Green Angiography ◽

Pathologic Myopia ◽

Swept Source ◽

Swept Source Oct ◽

Ciliary Arteries ◽

The Relationship ◽

Myopic Cnv

PurposeTo determine the connection between myopic choroidal neovascularisations (CNVs) and intrascleral vessels examined by swept-source optical coherence tomography (OCT).MethodsThe data of 124 eyes of 112 consecutive patients with myopic CNVs were retrospectively analysed. A myopic CNV was defined as a CNV occurring in eyes with pathologic myopia based on the META-PM study classification. The images obtained by swept-source OCT were analysed to determine the relationship between perforating scleral vessels and CNVs. The continuity of the scleral vessels and the CNV was also analysed. The OCT angiographic (OCTA) characteristics of the myopic CNVs at the active, scar and atrophic phases were also analysed.ResultsOCTA images showed that CNVs had blood flow in the active, scar and atrophic phases. Scleral perforating vessels were detected just below or around the CNV in 93 eyes (75%). In 10 of the 93 eyes, the scleral vessels and CNV appeared to be continuous through a defect of Bruch’s membrane in the OCT images. Indocyanine green angiography showed that these perforating vessels were intrascleral arteries originating from the short posterior ciliary arteries (SPCAs).ConclusionsSwept-source OCT showed that some of the myopic CNVs were continuous with scleral vessels mainly the SPCA. Further studies to confirm angiographical continuity between these two components are necessary.

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