Journal of neurosurgery
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Journal of neurosurgery · Aug 2012
Influence of hemodynamics on recanalization of totally occluded intracranial aneurysms: a patient-specific computational fluid dynamic simulation study.
Some totally occluded intracranial aneurysms may recur. The role of hemodynamic mechanisms in this process remains to be elucidated. The authors used computational fluid dynamic analysis and investigated the local hemodynamic characteristics at the aneurysm neck before and after total embolization, attempting to identify hemodynamic risk factors leading to recurrence of totally embolized aneurysms. ⋯ Higher WSS at the treated aneurysm neck after total embolization can be an important hemodynamic factor that contributes to aneurysm recurrence after endovascular treatment.
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Journal of neurosurgery · Aug 2012
Case ReportsEndoscopic indocyanine green video angiography in aneurysm surgery: an innovative method for intraoperative assessment of blood flow in vasculature hidden from microscopic view.
Recently, intraoperative fluorescence video angiography using indocyanine green (ICG) has been widely used in aneurysm surgery. This is a simple and useful method to confirm complete occlusion of the aneurysm lumen and preservation of blood flow in the arteries around the aneurysm. However, the observation field of ICG video angiography is limited under a microscope, making it difficult to confirm the flow in the arteries behind the parent arteries or aneurysm. ⋯ Then, ICG was intravenously administered, and the fluorescence in the vessels was observed via the endoscope as well as under the microscope. The blood flow in the perforating arteries was clearly identified, and no procedural complication occurred. The authors conclude that the technique is very useful and facilitates intraoperative real-time assessment of the patency of perforating arteries behind parent arteries or aneurysms.