Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patency
Background: The fluorescein videoangiography (FL-VAG) has become a valuable adjunct tool in vascular neurosurgery. This work describes using the FL-VAG during bypass surgery and proposes a classification method for evaluating surgical results. Methods: We analyzed 26 patients with 50 cerebral bypass...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-07-01
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| Series: | World Neurosurgery: X |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139724000188 |
| _version_ | 1797260342394355712 |
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| author | Edgar Nathal Javier Degollado-García Héctor A. Rodríguez-Rubio Alfredo Bonilla-Suástegui Alejandro Serrano-Rubio |
| author_facet | Edgar Nathal Javier Degollado-García Héctor A. Rodríguez-Rubio Alfredo Bonilla-Suástegui Alejandro Serrano-Rubio |
| author_sort | Edgar Nathal |
| collection | DOAJ |
| description | Background: The fluorescein videoangiography (FL-VAG) has become a valuable adjunct tool in vascular neurosurgery. This work describes using the FL-VAG during bypass surgery and proposes a classification method for evaluating surgical results. Methods: We analyzed 26 patients with 50 cerebral bypasses from September 2018 to September 2022. We used a three grades classification method based on the pass of intravenous fluorescein through the anastomosis. Grade 1 represents the synchronous and total filling of the ''T'' shape (''green T″) formed by the donor and recipient vessel, Grade 2, the asynchronous filling of the anastomosis (incomplete/asynchronous ''green T″), and Grade 3, a non-patent anastomosis (absence of ''green T″). Results: Of the 26 patients, 8 underwent one bypass, 14 underwent double bypass, 2 underwent three bypasses, and 2 underwent four bypasses in two different interventions. The type of bypass was end-to-side anastomosis in 47 (94%) cases, internal maxillary artery to middle cerebral artery bypass with a radial artery graft (IMax-MCA anastomosis) in 2 (4%), and PICA-VA transposition in one (2%). We made 24 (48%) bypasses on the right side and 26 (52%) on the left side. After the initial surgery, thirty-nine (78%) bypasses were considered as Grade 1, 5 (10%) as Grade 2, and 6 (12%) as Grade 3. After intraoperative bypass patency assessment (IBPA), 45 (90%) of the bypasses were considered Grade 1 and remained patent on CTA. Conclusions: Using FL-VAG and a three-tier classification method is a reliable tool to predict bypass patency. It is safe, low-risk, and available worldwide. |
| first_indexed | 2024-04-24T23:23:48Z |
| format | Article |
| id | doaj.art-6633a515f1a44a34b0c19c0ecb6c375e |
| institution | Directory Open Access Journal |
| issn | 2590-1397 |
| language | English |
| last_indexed | 2024-04-24T23:23:48Z |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj.art-6633a515f1a44a34b0c19c0ecb6c375e2024-03-16T05:09:13ZengElsevierWorld Neurosurgery: X2590-13972024-07-0123100287Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patencyEdgar Nathal0Javier Degollado-García1Héctor A. Rodríguez-Rubio2Alfredo Bonilla-Suástegui3Alejandro Serrano-Rubio4Corresponding author. Department of Vascular Neurosurgery Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suarez”, Insurgentes Sur 3877, Tlalpan, 14263, Ciudad de México, USA.; Department of Vascular Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City USADepartment of Vascular Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City USADepartment of Vascular Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City USADepartment of Vascular Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City USADepartment of Vascular Neurosurgery, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City USABackground: The fluorescein videoangiography (FL-VAG) has become a valuable adjunct tool in vascular neurosurgery. This work describes using the FL-VAG during bypass surgery and proposes a classification method for evaluating surgical results. Methods: We analyzed 26 patients with 50 cerebral bypasses from September 2018 to September 2022. We used a three grades classification method based on the pass of intravenous fluorescein through the anastomosis. Grade 1 represents the synchronous and total filling of the ''T'' shape (''green T″) formed by the donor and recipient vessel, Grade 2, the asynchronous filling of the anastomosis (incomplete/asynchronous ''green T″), and Grade 3, a non-patent anastomosis (absence of ''green T″). Results: Of the 26 patients, 8 underwent one bypass, 14 underwent double bypass, 2 underwent three bypasses, and 2 underwent four bypasses in two different interventions. The type of bypass was end-to-side anastomosis in 47 (94%) cases, internal maxillary artery to middle cerebral artery bypass with a radial artery graft (IMax-MCA anastomosis) in 2 (4%), and PICA-VA transposition in one (2%). We made 24 (48%) bypasses on the right side and 26 (52%) on the left side. After the initial surgery, thirty-nine (78%) bypasses were considered as Grade 1, 5 (10%) as Grade 2, and 6 (12%) as Grade 3. After intraoperative bypass patency assessment (IBPA), 45 (90%) of the bypasses were considered Grade 1 and remained patent on CTA. Conclusions: Using FL-VAG and a three-tier classification method is a reliable tool to predict bypass patency. It is safe, low-risk, and available worldwide.http://www.sciencedirect.com/science/article/pii/S2590139724000188Bypass surgeryCerebral revascularizationFluorescein videoangiographyMicrosurgeryVascular neurosurgery |
| spellingShingle | Edgar Nathal Javier Degollado-García Héctor A. Rodríguez-Rubio Alfredo Bonilla-Suástegui Alejandro Serrano-Rubio Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patency World Neurosurgery: X Bypass surgery Cerebral revascularization Fluorescein videoangiography Microsurgery Vascular neurosurgery |
| title | Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patency |
| title_full | Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patency |
| title_fullStr | Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patency |
| title_full_unstemmed | Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patency |
| title_short | Fluorescein videoangiography (FL-VAG) as a predictor of cerebral bypass patency |
| title_sort | fluorescein videoangiography fl vag as a predictor of cerebral bypass patency |
| topic | Bypass surgery Cerebral revascularization Fluorescein videoangiography Microsurgery Vascular neurosurgery |
| url | http://www.sciencedirect.com/science/article/pii/S2590139724000188 |
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