Intraoperative angiography for neurovascular disease in the prone or three-quarter prone position
| Autor: | Shih-Shan Lang, Eric Eskioglu, Robert A. Mericle |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Intracranial Arteriovenous Malformations Male medicine.medical_specialty Microsurgery medicine.medical_treatment Glasgow Outcome Scale Arteriovenous Malformations Intraoperative Period Femoral sheath medicine Prone Position Humans Craniotomy Aged Aged 80 and over Central Nervous System Vascular Malformations medicine.diagnostic_test business.industry Laminectomy Middle Aged Neurovascular bundle Surgery Cerebral Angiography Prone position medicine.anatomical_structure Spinal Cord Angiography Female Neurology (clinical) Radiology business Cerebral angiography |
| Zdroj: | Surgical neurology. 65(3) |
| ISSN: | 0090-3019 |
| Popis: | Background Intraoperative angiography for neurovascular disease has gained wide acceptance as a useful tool. There are few published cases of intraoperative angiography performed in the prone or three-quarter prone position, and the transradial approach has not previously been described for this situation. Methods We retrospectively reviewed our last 177 consecutive cases of intraoperative angiography performed for neurovascular disease. Of these cases, 21 were performed in the prone or three-quarter prone position. Two different approaches were used: (1) a previously described extended femoral sheath approach (13 cases) and (2) a newly described transradial approach (8 cases). Results All 21 intraoperative angiograms were successfully completed in the prone or three-quarter prone position. This enabled us to make additional surgical adjustments when necessary or to conclude the operation. One complication, a dissection of the brachial artery, occurred during one intraoperative angiographic procedure. Conclusions Intraoperative angiography can be performed in the prone or three-quarter prone position with good efficacy and safety. The transfemoral route has the advantage of familiarity but has disadvantages of poor sterility at access site, possible kinking or thrombosis of the sheath, and possible skin injury while resting on the tubing during long procedures. The transradial route has advantages of continuous access to the entry site throughout the surgical procedure and ease of catheterization of vertebral arteries for occipital and suboccipital lesions. However, the transradial route has the disadvantage of working from an unfamiliar approach, especially for spinal arteriovenous malformations. |
| Databáze: | OpenAIRE |
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