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Related Experiment Video

Updated: Jul 4, 2025

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Can exoscope improve brain AVMs surgery?

Serena Tola1, Federico Capelli1, Alessandro Della Puppa1

  • 1Department of Neuroscience, Neurosurgery Clinic, Psychology, Pharmacology and Child Health (NEUROFARBA), Careggi University Hospital and University of Florence, Italy.

Neurosurgical Focus: Video
|January 29, 2024
PubMed
Summary

Exoscope use in brain arteriovenous malformation (AVM) surgery enhances visualization and aids in detecting residual AVMs using indocyanine green video angiography (ICG-VA). This technology improves surgical outcomes for complex AVM cases.

Keywords:
AVMICG-VAarteriovenous malformationexoscopeindocyanine green video angiographymicrosurgery

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Area of Science:

  • Neurosurgery
  • Medical Technology
  • Vascular Surgery

Background:

  • Exoscopes offer improved visualization in microsurgery.
  • Limited reports exist on exoscope application in brain arteriovenous malformation (AVM) surgery.

Purpose of the Study:

  • To describe the technical implications of using an exoscope for brain AVM surgery.
  • To highlight the utility of indocyanine green video angiography (ICG-VA) in exoscope-assisted AVM resection.

Main Methods:

  • Case illustration of a Spetzler-Martin grade III hemorrhagic right frontoinsular AVM resection.
  • Utilized the Olympus ORBEYE 4K-3D exoscope system.
  • Employed indocyanine green video angiography (ICG-VA) for intraoperative assessment.

Main Results:

  • The exoscope provided an ample field of view and magnification (up to ×24).
  • ICG-VA effectively visualized AVM hemodynamics and detected potential residual arterialization.
  • Successful resection of the described AVM was achieved.

Conclusions:

  • Exoscope-assisted surgery is a viable option for brain AVM resection.
  • ICG-VA is a valuable tool for assessing AVMs during exoscope surgery.
  • Enhanced visualization and hemodynamic assessment contribute to improved surgical precision.