Quantitative Flowmetry of Parent and Branching Arteries during Surgical Treatment of Cerebral Aneurysma
Abstract
Aim: To present own experience with quantitative flow measurement (flowmetry) of parent and branching arteries during surgical treatment of cerebral aneurysms. Material and methods: Intraoperative flowmetry enables quantitative blood flow measurement in ml/min on the basis of integration of the ultrasound beam transit time difference.
Between 1/2011 and 5/2013, quantitative blood flow measurement of parent and branching arteries was performed in 23 patients during cerebral aneurysm surgery. The mean age was 52.1 years (30–73).
Incidental aneurysms were present in 19 cases; four patients had subarachnoid hemorrhage (Hunt-Hess I in two and Hunt-Hess II in two). Location: middle cerebral artery aneurysm – 16 patients, anterior communication artery aneurysms – four patients, posterior communication artery aneurysm – two patients, and distal anterior cerebral artery aneurysm – one patient.
Size of the aneurysm: small (≤ 7 mm) in 10 patients, middle (8–14 mm) in nine patients, large (15–24 mm) in three patients and giant (≥ 25 mm) in one patient. Results: Thirty-day postoperative results: good recovery in 21 cases and moderate disability in two cases.
No postoperative ischemia was recorded in the group of patients. A significant perioperative blood flow decline was recorded in four patients; this was due to vasospasm in two and the flow normalized after papaverin administration.
Clip correction was necessary in two patients (8.7%) followed by normalization of the flow. Conclusions: Quantitative blood flow measurement contributes to improved perioperative safety in cerebral aneurysms surgery.
Role of flowmetry is irreplaceable in detection of parent and45 branching artery stenosis/occlusion.