Journal
OPERATIVE NEUROSURGERY
Volume 18, Issue 6, Pages 652-659Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ons/opz282
Keywords
Cerebrovascular surgery; Hyperperfusion syndrome; Indocyanine green videoangiography; Intraoperative prediction; Superficial temporal artery-middle cerebral artery bypass
Categories
Funding
- JSPS KAKENHI [JP 18K16572]
Ask authors/readers for more resources
BACKGROUND: Intraoperative prediction of postoperative cerebral hyperperfusion syndrome (CHS) after cerebrovascular bypass surgery is challenging. OBJECTIVE: To conduct a retrospective case-control study with indocyanine green (ICG) intensity analysis of the superficial temporal artery-middle cerebral artery (STA-MCA) bypass and investigate whether its washout pattern might be a marker for intraoperative prediction of CHS. METHODS: Between 2012 and 2018, 6 of 112 patients (5.4%) that underwent STA-MCA bypass exhibited CHS. We selected 5 patients with CHS (3 with atherosclerotic cerebrovascular disease [ASCVD] and 2 with moyamoya) and 15 patients without CHS (60% ASCVD and 40% moyamoya) as a matched control group. During prebypass and postbypass, washout times (WTs) for the first 10%, 25%, 50%, and 75% of maximum ICG intensity measured in the whole-camera field were compared between groups. The changes in WT (Delta WT) from prebypass to postbypass for each ICG intensity level were compared between groups. The cutoff Delta WTs, sensitivities, and specificities were also calculated. RESULTS: Postbypass WTs were significantly longer in the CHS group than the control group at all ICG intensities (P < .05). Delta WT was significantly greater in the CHS group than the control group for the first 10%, 25%, and 50% ICG intensities (P < .001). A cutoff Delta WT of >= 2.66 s for the first 50% ICG intensity showed a sensitivity of 100% and specificity of 100%. CONCLUSION: We found that a Delta WT >= 2.66 s for the first 50% ICG intensity could be an intraoperative predictive factor for CHS.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available