Early Experience of Surgical Planning for STA-MCA Bypass Using Virtual Reality.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 17 01 2023
revised: 23 02 2023
accepted: 23 02 2023
medline: 5 6 2023
pubmed: 12 3 2023
entrez: 11 3 2023
Statut: ppublish

Résumé

The superficial temporal artery (STA)-to-middle cerebral artery (MCA) bypass requires precise preoperative planning, and 3-dimensional virtual reality (VR) models have recently been used to optimize planning of STA-MCA bypass. In the present report, we have described our experience with VR-based preoperative planning of STA-MCA bypass. Patients from August 2020 to February 2022 were analyzed. For the VR group, using 3-dimensional models from the patients' preoperative computed tomography angiograms, VR was used to locate the donor vessels, potential recipient, and anastomosis sites and plan the craniotomy, which were referenced throughout surgery. Computed tomography angiograms or digital subtraction angiograms were used to plan the craniotomy for the control group. The procedure time, bypass patency, craniotomy size, and postoperative complication rates were assessed. The VR group included 17 patients (13 women; age, 49 ± 14 years) with Moyamoya disease (76.5%) and/or ischemic stroke (29.4%). The control group included 13 patients (8 women; age, 49 ± 12 years) with Moyamoya disease (92.3%) and/or ischemic stroke (7.3%). For all 30 patients, the preoperatively planned donor and recipient branches were effectively translated intraoperatively. No significant difference were found in the procedure time or craniotomy size between the 2 groups. Bypass patency was 94.1% for the VR group (16 of 17) and 84.6% for the control group (11 of 13). No permanent neurological deficits occurred in either group. Our early experience has shown that VR can serve as a useful, interactive preoperative planning tool by enhancing visualization of the spatial relationship between the STA and MCA without compromising the surgical results.

Sections du résumé

BACKGROUND BACKGROUND
The superficial temporal artery (STA)-to-middle cerebral artery (MCA) bypass requires precise preoperative planning, and 3-dimensional virtual reality (VR) models have recently been used to optimize planning of STA-MCA bypass. In the present report, we have described our experience with VR-based preoperative planning of STA-MCA bypass.
METHODS METHODS
Patients from August 2020 to February 2022 were analyzed. For the VR group, using 3-dimensional models from the patients' preoperative computed tomography angiograms, VR was used to locate the donor vessels, potential recipient, and anastomosis sites and plan the craniotomy, which were referenced throughout surgery. Computed tomography angiograms or digital subtraction angiograms were used to plan the craniotomy for the control group. The procedure time, bypass patency, craniotomy size, and postoperative complication rates were assessed.
RESULTS RESULTS
The VR group included 17 patients (13 women; age, 49 ± 14 years) with Moyamoya disease (76.5%) and/or ischemic stroke (29.4%). The control group included 13 patients (8 women; age, 49 ± 12 years) with Moyamoya disease (92.3%) and/or ischemic stroke (7.3%). For all 30 patients, the preoperatively planned donor and recipient branches were effectively translated intraoperatively. No significant difference were found in the procedure time or craniotomy size between the 2 groups. Bypass patency was 94.1% for the VR group (16 of 17) and 84.6% for the control group (11 of 13). No permanent neurological deficits occurred in either group.
CONCLUSIONS CONCLUSIONS
Our early experience has shown that VR can serve as a useful, interactive preoperative planning tool by enhancing visualization of the spatial relationship between the STA and MCA without compromising the surgical results.

Identifiants

pubmed: 36906090
pii: S1878-8750(23)00261-9
doi: 10.1016/j.wneu.2023.02.113
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e44-e52

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Nora C Kim (NC)

Department of Neurosurgery, NYU Langone Health, New York, New York, USA.

Karl L Sangwon (KL)

Department of Neurosurgery, NYU Langone Health, New York, New York, USA.

Eytan Raz (E)

Department of Radiology, NYU Langone Health, New York, New York, USA.

Maksim Shapiro (M)

Department of Radiology, NYU Langone Health, New York, New York, USA.

Caleb Rutledge (C)

Department of Neurosurgery, NYU Langone Health, New York, New York, USA.

Peter K Nelson (PK)

Department of Neurosurgery, NYU Langone Health, New York, New York, USA; Department of Radiology, NYU Langone Health, New York, New York, USA.

Howard A Riina (HA)

Department of Neurosurgery, NYU Langone Health, New York, New York, USA; Department of Radiology, NYU Langone Health, New York, New York, USA.

Erez Nossek (E)

Department of Neurosurgery, NYU Langone Health, New York, New York, USA. Electronic address: Erez.Nossek@nyulangone.org.

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Classifications MeSH