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Cortical ICG Videography for Quantification of Acute Hypoperfusion After Subarachnoid Hemorrhage - A Feasibility Study.
MedLine Citation:
PMID:  22743358     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Acute neurological deficits after SAH correlate with outcome, and a phase of acute hypoperfusion has been characterized recently. ICG videography is an established intraoperative imaging technique with important descriptive potential. OBJECTIVE:: To analyze whether ICG can be used to analyze and confirm perfusion changes early after SAH. METHODS:: We prospectively enrolled 11 patients with acute SAH within the last 24hrs and 14 patients undergoing surgery for unruptured aneurysms. Cortical ICG videography was performed, and offline analysis included the arterial, parenchymal, and venous cortical compartment. Transit times, signal gradient, maximum of fluorescence intensity, as well as the area under the curve were calculated as surrogate markers for perfusion characteristics. RESULTS:: Arterial, parenchymal, and venous transit times were comparable in both groups. Velocity of signal change in SAH patients was significantly lower in all three compartments (p<0.001, p<0.01, p<0.001 resp.), as was the peak fluorescence intensity (p<0.001). In SAH patients, fluorescence intensity did not vary between areas with and without diffuse cortical blood. Area under the curve analysis showed significantly lower values in SAH patients compared to the control group (p<0.001). CONCLUSION:: Cortical ICG videography and analysis is feasible during surgery. Patients early after SAH feature a significantly lower velocity of signal change, lower peak of fluorescence intensity, and lower overall area under the curve, but similar transit times. This technique can be used to quantify perfusion alteration, in this case acute SAH, and may be used as an adapted measurement tool for intraoperative therapy.
Gerrit Alexander Schubert; Marcel Seiz-Rosenhagen; Martin Ortler; Marcus Czabanka; Kai-Michael Scheufler; Claudius Thomé
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-27
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Clinical Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria 2Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Germany.
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