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Intraoperative microvascular Doppler sonography in aneurysm surgery
J E Bailes1, L S Tantuwaya, T Fukushima
1Department of Neurological Surgery, Allegheny Neuroscience Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Neurosurgery
|May 1, 1997
Summary
Intraoperative microvascular Doppler sonography effectively assesses cerebral hemodynamics during aneurysm surgery. This safe and reliable technique confirms aneurysm obliteration and vessel patency, often replacing intraoperative angiography.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Diagnostic Imaging
Background:
- Intracranial aneurysms pose significant risks, necessitating precise surgical techniques.
- Accurate intraoperative assessment of cerebral hemodynamics is crucial for successful aneurysm repair.
- Current methods like angiography have limitations in real-time assessment.
Purpose of the Study:
- To evaluate the efficacy and reliability of intraoperative microvascular Doppler sonography.
- To assess its role in confirming cerebral hemodynamics and aneurysm obliteration.
- To compare its utility against traditional intraoperative angiography.
Main Methods:
- Microvascular Doppler sonography with a 20-MHz, 1-mm probe was used in 35 patients undergoing treatment for 42 intracranial aneurysms.
- The technique assessed parent vessel and branching artery patency before and after clip application.
- Doppler findings were validated using intraoperative or postoperative angiography.
Main Results:
- The microprobe successfully insonated all Circle of Willis vessels, major branches, and perforating arteries.
- Doppler sonography identified stenosis or occlusion in 31% of patients, guiding clip adjustments.
- All Doppler findings correlated with angiography, and no complications occurred.
Conclusions:
- Intraoperative microvascular Doppler sonography is a safe, effective, and reliable tool for aneurysm surgery.
- It accurately documents vessel patency and aneurysm occlusion.
- This technique can often serve as a substitute for intraoperative angiography, offering cost-effectiveness.