Development of and Clinical Experience with a Simple Device for Performing Intraoperative Fluorescein Fluorescence Cerebral Angiography: Technical Notes
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- ICHIKAWA Tsuyoshi
- Department of Neurosurgery, Fukushima Red Cross Hospital
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- SUZUKI Kyouichi
- Department of Neurosurgery, Fukushima Red Cross Hospital
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- WATANABE Yoichi
- Department of Neurosurgery, Fukushima Red Cross Hospital
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- SATO Taku
- Department of Neurosurgery, Fukushima Medical University
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- SAKUMA Jun
- Department of Neurosurgery, Fukushima Medical University
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- SAITO Kiyoshi
- Department of Neurosurgery, Fukushima Medical University
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抄録
To perform intraoperative fluorescence angiography (FAG) under a microscope without an integrated FAG function with reasonable cost and sufficient quality for evaluation, we made a small and easy to use device for fluorescein FAG (FAG filter). We investigated the practical use of this FAG filter during aneurysm surgery, revascularization surgery, and brain tumor surgery. The FAG filter consists of two types of filters: an excitatory filter and a barrier filter. The excitatory filter excludes all wavelengths except for blue light and the barrier filter passes long waves except for blue light. By adding this FAG filter to a microscope without an integrated FAG function, light from the microscope illuminating the surgical field becomes blue, which is blocked by the barrier filter. We put the FAG filter on the objective lens of the operating microscope correctly and fluorescein sodium was injected intravenously or intra-arterially. Fluorescence (green light) from vessels in the surgical field and the dyed tumor were clearly observed through the microscope and recorded by a memory device. This method was easy and could be performed in a short time (about 10 seconds). Blood flow of small vessels deep in the surgical field could be observed. Blood flow stagnation could be evaluated. However, images from this method were inferior to those obtained by currently commercially available microscopes with an integrated FAG function. In brain tumor surgery, a stained tumor on the brain surface could be observed using this method. FAG could be performed with a microscope without an integrated FAG function easily with only this FAG filter.
収録刊行物
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 56 (3), 141-149, 2016
一般社団法人 日本脳神経外科学会