Efficacy of indocyanine green videography and real-time evaluation by FLOW 800 in the resection of a spinal cord hemangioblastoma in a child

2012 ◽  
Vol 9 (4) ◽  
pp. 428-431 ◽  
Author(s):  
Tetsuya Ueba ◽  
Hiroshi Abe ◽  
Juntaro Matsumoto ◽  
Toshio Higashi ◽  
Tooru Inoue
Keyword(s):  
Spinal Cord ◽  
Indocyanine Green ◽  
Real Time ◽  
Spinal Cord Tumor ◽  
Gait Disturbance ◽  
Feeding Artery ◽  
Average Signal Intensity ◽  
Spinal Mri ◽  
Flow 800 ◽  
Time Evaluation

A 19-month-old child was gradually suffering from gait disturbance and was referred by his pediatrician to the authors' institution. Spinal MRI showed Gd-enhanced spinal cord tumor and congestive myelopathy. Intraoperatively the lesion was seen to be a hemangioblastoma. Because discrimination of the arterialized draining veins from the feeding arteries was difficult, indocyanine green videography was conducted to differentiate them. Real-time evaluation by FLOW 800 revealed that the slope of the average signal intensity in the feeding artery was steeper than that of the arterialized veins. The tumor was successfully resected, and postoperative indocyanine green videography showed total removal of the tumor as a signal-negative region; the circulation time between the feeding artery and the main draining vein was prolonged from 2.5 to 5.5 seconds. Indocyanine green videography and real-time evaluation by FLOW 800 were objective and effective for the excision of a tumor retaining the arteriovenous shunt. The patient recovered from congestive myelopathy and gait disturbance.

The outcome of real-time evaluation of biliary flow using near-infrared fluorescence cholangiography with Indocyanine green in biliary atresia surgery

2019 ◽  
Vol 54 (12) ◽  
pp. 2574-2578 ◽  
Author(s):  
Yusuke Yanagi ◽  
Koichiro Yoshimaru ◽  
Toshiharu Matsuura ◽  
Yuichi Shibui ◽  
Kenichi Kohashi ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Biliary Atresia ◽  
Real Time ◽  
Near Infrared ◽  
Near Infrared Fluorescence ◽  
Time Evaluation

Benefits and Limitations of Indocyanine Green Fluorescent Image-Guided Surgery for Spinal Intramedullary Tumors

2017 ◽  
Vol 13 (6) ◽  
pp. 746-754 ◽  
Author(s):  
Toshihiro Takami ◽  
Kentaro Naito ◽  
Toru Yamagata ◽  
Nobuyuki Shimokawa ◽  
Kenji Ohata
Keyword(s):  
Spinal Cord ◽  
Indocyanine Green ◽  
Real Time ◽  
Cavernous Malformation ◽  
Dorsal Surface ◽  
Vascular Tumors ◽  
Image Guided Surgery ◽  
Intramedullary Tumors ◽  
Guided Surgery ◽  
Image Guided

Abstract BACKGROUND Intraoperative image guidance using near-infrared indocyanine green videoangiography (ICG-VA) has been used to provide real-time angiographic images during vascular or brain tumor surgery, and it is also being used for spine surgery. OBJECTIVE To further investigate the benefits and limitations of ICG-VA image-guided surgery for spinal intramedullary tumors through retrospective study. METHODS ICG-VA was used in 48 cases that were treated surgically over the past 5 yr. The pathological diagnoses of the tumors included astrocytic tumor, ependymal tumor, cavernous malformation, and hemangioblastoma. RESULTS Localization of normal spinal arteries and veins on the dorsal surface of the spinal cord helped the surgeons determine the length or point of myelotomy. Well-demarcated tumor stain was recognized in limited cases of anaplastic or highly vascularized tumors, whereas the location of cavernous malformation was recognized as an avascular area on the dorsal surface of the spinal cord. Feeding arteries and tumor stain were well differentiated from draining veins in dorsal hemangioblastomas, but not in intramedullary deep-seated or ventral tumors. The preservation of small perforating branches of the anterior spinal artery after successful resection of the tumor could be well visualized. CONCLUSION ICG-VA can provide real-time information about vascular flow dynamics during the surgery of spinal intramedullary tumors, and it may help surgeons localize the normal circulation of the spinal cord, as well as the feeding arteries and draining veins, especially in highly vascular tumors. However, the benefits of intraoperative ICG-VA might be limited for intramedullary deep-seated or ventral tumors.

Real-Time Evaluation of Site Characterization to Direct and Conclude Exploration

2001 ◽  
Vol 1755 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Andrew J. Graettinger ◽  
Thanaporn Supriyasilp ◽  
S. Rocky Durrans
Keyword(s):  
Real Time ◽  
Site Characterization ◽  
Time Evaluation

Posterior approach for cervical intramedullary arteriovenous malformation with diffuse-type nidus

1999 ◽  
Vol 91 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Kenji Ohata ◽  
Toshihiro Takami ◽  
Alaa El-Naggar ◽  
Michiharu Morino ◽  
Akimasa Nishio ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Poor Prognosis ◽  
Posterior Approach ◽  
The Other ◽  
Anterior Spinal Artery ◽  
Neural Element ◽  
Feeding Artery ◽  
Diffuse Type ◽  
Content Type ◽  
Fine Print

✓ The treatment of spinal intramedullary arteriovenous malformations (AVMs) with a diffuse-type nidus that contains a neural element poses different challenges compared with a glomus-type nidus. The surgical elimination of such lesions involves the risk of spinal cord ischemia that results from coagulation of the feeding artery that, at the same time, supplies cord parenchyma. However, based on evaluation of the risks involved in performing embolization, together with the frequent occurrence of reperfusion, which necessitates frequent reembolization, the authors consider surgery to be a one-stage solution to a disease that otherwise has a very poor prognosis. Magnetic resonance (MR) imaging revealed diffuse-type intramedullary AVMs in the cervical spinal cords of three patients who subsequently underwent surgery via the posterior approach. The AVM was supplied by the anterior spinal artery in one case and by both the anterior and posterior spinal arteries in the other two cases. In all three cases, a posterior median myelotomy was performed up to the vicinity of the anterior median fissure that divided the spinal cord together with the nidus, and the feeding artery was coagulated and severed at its origin from the anterior spinal artery. In the two cases in which the posterior spinal artery fed the AVM, the feeding artery was coagulated on the dorsal surface of the spinal cord. Neurological outcome improved in one patient and deteriorated slightly to mildly in the other two patients. Postoperative angiography demonstrated complete disappearance of the AVM in all cases. Because of the extremely poor prognosis of patients with spinal intramedullary AVMs, this surgical technique for the treatment of diffuse-type AVMs provides acceptable operative outcome. Surgical intervention should be considered when managing a patient with a diffuse-type intramedullary AVM in the cervical spinal cord.

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