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Indocyanine greenを用いた術中蛍光血管撮影の新たな利用法として,経時的輝度変化測定の有用性を報告する.症例は61歳女性,未破裂中大脳動脈瘤の症例.通常の前頭側頭開頭を行い,Carl Zeiss社製顕微鏡OPMI^[○!R] PenteroのINFRARED 800とFLOW 800システムを用いて,動脈瘤の残存血流,末梢血管,末梢血管領域の脳表の輝度を観察した.脳表,動脈瘤の単位時間当たりの輝度変化を相対的かつ経時的に評価することにより,正常な脳表血流と動脈瘤の不完全閉塞による血流残存が明瞭に評価された.OPMI^[○!R] PenteroのINFRARED 800とFLOW 800システムは,簡便な相対的経時的輝度変化評価法としてきわめて有用と思われた.
OBJECT: The aim of the present study is to assess whether a new technique of surgical microscope-based indocyanine green (ICG) videoangiography (VAG) to assess cortical blood flow is suitable for intraoperative confirmation of successful aneurysm clipping. CASE REPORT: We used a Carl Zeiss Surgical Microscope OPMI^[○!R] Pentero INFRARED 800 and FLOW 800 system (Carl Zeiss Co., Tokyo, Japan), in the case of a 61-year-old woman with an unruptured left middle cerebral artery aneurysm. FLOW 800 is a new tool to analyze video data subsequent its acquisition with ICGVAG. Images were excellent and enabled a real-time surgical assessment if the structures of interest were visible to the surgeon's eye under the microscope, including vessels, perforating arteries, or residual aneurysm neck. Blood flow intensity data were revealed relative to alterations in fluorescence intensity. CONCLUSIONS: ICGVAG and the FLOW 800 system provide simple, reliable, real-time and rapid intraoperative assessment of relative cortical perfusion. This technique may help to improve the quality of neurosurgical procedures.
