[Intraoperative angiography in treatment of neurovascular disorders]

To investigate the value of intraoperative angiography in treatment of cerebrovascular disorders.

Between July 2003 and July 2005, 38 consecutive patients of cerebrovascular disorders, 21 males and 17 females, aged 33.7, 27 with arteriovenous malformations (AVMs) with a nidus 2 - 8 cm in diameter among which 7 had a diameter >or= 6 cm, and 11 cases with aneurysms among which 3 cases being with an aneurysm >or= 2.5 cm in diameter, and 4 being at the Hunt-Hess grade 1, 4 at the grade 2, and 3 at the grade 3 preoperatively, underwent cerebrovascular surgery assisted with intraoperative angiography. After intubation was achieved and general anesthesia was administrated, a catheter was inserted into the right femoral artery to the intracranial artery related to the surgery. When the lesion was managed, such as the AVMs were resected or the aneurysm was clipped, intraoperative angiography was performed so as to monitor the surgical process.

Nine of the 38 patients underwent emergency operation because of acute intracranial hemorrhage without preoperative angiography and intraoperative angiography conformed the diagnosis of AVM in 7 of them and the diagnosis of aneurysms in the other 2 patients. Intraoperative angiography showed that satisfying management was achieved in 36 of the 38 patients (94.7%), and residue of ophthalmic artery aneurysm was seen in 1 patient which underwent clip adjustment later. Only 1 patient with posterior fossa AVM had residual AVM that was resected later. There was no operation mortality, no unexpected major artery occlusion, and no complication attributable to angiography. Intraoperative angiography lasted 53.4 minutes (20 - 125 minutes).

Intraoperative angiography is able to detect unexpected residual aneurysm, AVM nidus, and major artery occlusion, helps modify the technical faults, thus preventing re-operation, and decreases the complication rate in cerebrovascular surgery.