Amended Intraoperative Neuronavigation: Three-Dimensional Vascular Roadmapping with Selective Rotational Digital Subtraction Angiography.
Angiography, Digital Subtraction
/ methods
Feasibility Studies
Humans
Imaging, Three-Dimensional
/ methods
Intracranial Aneurysm
/ diagnostic imaging
Microsurgery
/ methods
Middle Cerebral Artery
/ diagnostic imaging
Neuronavigation
/ methods
Neurosurgical Procedures
/ methods
Tomography, X-Ray Computed
Vascular Surgical Procedures
/ methods
Cerebrovascular neuronavigation
Intraoperative selective rotational digital subtraction angiography (3D-iDSA)
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
18
07
2019
revised:
09
12
2019
accepted:
10
12
2019
pubmed:
22
12
2019
medline:
25
3
2020
entrez:
22
12
2019
Statut:
ppublish
Résumé
Accuracy of intraoperative cerebrovascular neuronavigation is difficult to maintain because of the ongoing need for brain shift correction. By including 3-dimensional rotational intraoperative digital subtraction angiography (3D-iDSA), the intraoperative cerebrovascular neuronavigation can be updated and upgraded throughout the microneurosurgical procedure. The aim of this technical note is to demonstrate the feasibility and advantage of updating and upgrading the accuracy of targeted cerebrovascular neuronavigation with an intraoperative 3D-DSA dataset. A preoperative diagnostic selective 3D-DSA was registered with the neuronavigation software, followed by the automated segmentation of the vascular object of interest (an aneurysm in this case). After acquiring additional 3D-iDSA volumes, these steps were repeated, thereby updating the cerebrovascular roadmap and neuronavigation accuracy (i.e., brain shift correction). This technique was applied successfully in a patient who underwent elective microneurosurgical clipping of a right-sided middle cerebral artery (MCA) bifurcation aneurysm in a hybrid neurosurgical operating setting. After clipping of the MCA aneurysm, a selective 3D iDSA was performed that was then used to update the projection and accuracy of the initial 3D neurovascular object of interest (i.e., the aneurysm). In this revised rotational view, the projection refined the target segments of the clipped MCA aneurysm, the accuracy of clipping, and brain shift correction. 3D-iDSA vascular segmentations can update und upgrade the intraoperative neurovascular roadmap by thereby enhancing accuracy of cerebrovascular neuronavigation, as well as correcting brain shift. This technique is feasible within the hybrid operation room. Evaluation in larger series is required to support these findings.
Sections du résumé
BACKGROUND
BACKGROUND
Accuracy of intraoperative cerebrovascular neuronavigation is difficult to maintain because of the ongoing need for brain shift correction. By including 3-dimensional rotational intraoperative digital subtraction angiography (3D-iDSA), the intraoperative cerebrovascular neuronavigation can be updated and upgraded throughout the microneurosurgical procedure. The aim of this technical note is to demonstrate the feasibility and advantage of updating and upgrading the accuracy of targeted cerebrovascular neuronavigation with an intraoperative 3D-DSA dataset.
METHODS
METHODS
A preoperative diagnostic selective 3D-DSA was registered with the neuronavigation software, followed by the automated segmentation of the vascular object of interest (an aneurysm in this case). After acquiring additional 3D-iDSA volumes, these steps were repeated, thereby updating the cerebrovascular roadmap and neuronavigation accuracy (i.e., brain shift correction).
RESULTS
RESULTS
This technique was applied successfully in a patient who underwent elective microneurosurgical clipping of a right-sided middle cerebral artery (MCA) bifurcation aneurysm in a hybrid neurosurgical operating setting. After clipping of the MCA aneurysm, a selective 3D iDSA was performed that was then used to update the projection and accuracy of the initial 3D neurovascular object of interest (i.e., the aneurysm). In this revised rotational view, the projection refined the target segments of the clipped MCA aneurysm, the accuracy of clipping, and brain shift correction.
CONCLUSIONS
CONCLUSIONS
3D-iDSA vascular segmentations can update und upgrade the intraoperative neurovascular roadmap by thereby enhancing accuracy of cerebrovascular neuronavigation, as well as correcting brain shift. This technique is feasible within the hybrid operation room. Evaluation in larger series is required to support these findings.
Identifiants
pubmed: 31863893
pii: S1878-8750(19)33084-0
doi: 10.1016/j.wneu.2019.12.055
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
183-187Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.