The role of intraoperative micro-Doppler ultrasound in verifying proper clip placement in intracranial aneurysm surgery

E. Z. Kapsalaki, G. P. Lee, J. S. Robinson, A. A. Grigorian, K. N. Fountas

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

We present the results of a retrospective study employing intraoperative micro-Doppler ultrasonography (MDU) in verifying proper clip placement during cerebral aneurysmal surgery. One hundred and thirty-four patients surgically treated for 147 intracranial aneurysms were studied. Thirteen patients harboring 17 aneurysms were surgically treated on an elective basis, while 121 patients with 130 aneurysms, presented with subarachnoid hemorrhage (SAH). Blood flow velocities of the parent and adjacent vessels as well as the aneurysmal sac were measured using a Conforma Micro-Doppler (Cook Vascular Inc., Leechburg, PA, USA). Pre- and post-operative cerebral angiography was obtained in all our patients. In 23 aneurysms (15.6%) there was decreased or absent flow in the parent vessel or in one of the adjacent vessels after clipping. In another 19 aneurysms (12.9%), MDU demonstrated flow through the aneurysmal dome even though the aneurysmal neck appeared to be totally obliterated. Presence of SAH, anatomic location and size of the aneurysm were associated with improper clip placement in a statistically significant fashion. The false positive rate for MDU was 2% while there were no false negative findings in our study. MDU appears to be a non-invasive, reliable alternative methodology to intra-operative angiography. This inexpensive method may lend itself to routine usage in aneurysm surgery.

Original languageEnglish (US)
Pages (from-to)153-157
Number of pages5
JournalJournal of Clinical Neuroscience
Volume15
Issue number2
DOIs
StatePublished - Feb 1 2008

Fingerprint

Doppler Ultrasonography
Intracranial Aneurysm
Surgical Instruments
Aneurysm
Subarachnoid Hemorrhage
Cerebral Angiography
Blood Flow Velocity
Blood Vessels
Angiography
Retrospective Studies

Keywords

  • Aneurysm
  • Improper clip placement
  • Intraoperative ultrasound
  • Micro-Doppler
  • Partial occlusion

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neurology

Cite this

The role of intraoperative micro-Doppler ultrasound in verifying proper clip placement in intracranial aneurysm surgery. / Kapsalaki, E. Z.; Lee, G. P.; Robinson, J. S.; Grigorian, A. A.; Fountas, K. N.

In: Journal of Clinical Neuroscience, Vol. 15, No. 2, 01.02.2008, p. 153-157.

Research output: Contribution to journalArticle

Kapsalaki, E. Z. ; Lee, G. P. ; Robinson, J. S. ; Grigorian, A. A. ; Fountas, K. N. / The role of intraoperative micro-Doppler ultrasound in verifying proper clip placement in intracranial aneurysm surgery. In: Journal of Clinical Neuroscience. 2008 ; Vol. 15, No. 2. pp. 153-157.
@article{80b1359d88674322894ee92b41eb17fb,
title = "The role of intraoperative micro-Doppler ultrasound in verifying proper clip placement in intracranial aneurysm surgery",
abstract = "We present the results of a retrospective study employing intraoperative micro-Doppler ultrasonography (MDU) in verifying proper clip placement during cerebral aneurysmal surgery. One hundred and thirty-four patients surgically treated for 147 intracranial aneurysms were studied. Thirteen patients harboring 17 aneurysms were surgically treated on an elective basis, while 121 patients with 130 aneurysms, presented with subarachnoid hemorrhage (SAH). Blood flow velocities of the parent and adjacent vessels as well as the aneurysmal sac were measured using a Conforma Micro-Doppler (Cook Vascular Inc., Leechburg, PA, USA). Pre- and post-operative cerebral angiography was obtained in all our patients. In 23 aneurysms (15.6{\%}) there was decreased or absent flow in the parent vessel or in one of the adjacent vessels after clipping. In another 19 aneurysms (12.9{\%}), MDU demonstrated flow through the aneurysmal dome even though the aneurysmal neck appeared to be totally obliterated. Presence of SAH, anatomic location and size of the aneurysm were associated with improper clip placement in a statistically significant fashion. The false positive rate for MDU was 2{\%} while there were no false negative findings in our study. MDU appears to be a non-invasive, reliable alternative methodology to intra-operative angiography. This inexpensive method may lend itself to routine usage in aneurysm surgery.",
keywords = "Aneurysm, Improper clip placement, Intraoperative ultrasound, Micro-Doppler, Partial occlusion",
author = "Kapsalaki, {E. Z.} and Lee, {G. P.} and Robinson, {J. S.} and Grigorian, {A. A.} and Fountas, {K. N.}",
year = "2008",
month = "2",
day = "1",
doi = "10.1016/j.jocn.2006.11.006",
language = "English (US)",
volume = "15",
pages = "153--157",
journal = "Journal of Clinical Neuroscience",
issn = "0967-5868",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - The role of intraoperative micro-Doppler ultrasound in verifying proper clip placement in intracranial aneurysm surgery

AU - Kapsalaki, E. Z.

AU - Lee, G. P.

AU - Robinson, J. S.

AU - Grigorian, A. A.

AU - Fountas, K. N.

PY - 2008/2/1

Y1 - 2008/2/1

N2 - We present the results of a retrospective study employing intraoperative micro-Doppler ultrasonography (MDU) in verifying proper clip placement during cerebral aneurysmal surgery. One hundred and thirty-four patients surgically treated for 147 intracranial aneurysms were studied. Thirteen patients harboring 17 aneurysms were surgically treated on an elective basis, while 121 patients with 130 aneurysms, presented with subarachnoid hemorrhage (SAH). Blood flow velocities of the parent and adjacent vessels as well as the aneurysmal sac were measured using a Conforma Micro-Doppler (Cook Vascular Inc., Leechburg, PA, USA). Pre- and post-operative cerebral angiography was obtained in all our patients. In 23 aneurysms (15.6%) there was decreased or absent flow in the parent vessel or in one of the adjacent vessels after clipping. In another 19 aneurysms (12.9%), MDU demonstrated flow through the aneurysmal dome even though the aneurysmal neck appeared to be totally obliterated. Presence of SAH, anatomic location and size of the aneurysm were associated with improper clip placement in a statistically significant fashion. The false positive rate for MDU was 2% while there were no false negative findings in our study. MDU appears to be a non-invasive, reliable alternative methodology to intra-operative angiography. This inexpensive method may lend itself to routine usage in aneurysm surgery.

AB - We present the results of a retrospective study employing intraoperative micro-Doppler ultrasonography (MDU) in verifying proper clip placement during cerebral aneurysmal surgery. One hundred and thirty-four patients surgically treated for 147 intracranial aneurysms were studied. Thirteen patients harboring 17 aneurysms were surgically treated on an elective basis, while 121 patients with 130 aneurysms, presented with subarachnoid hemorrhage (SAH). Blood flow velocities of the parent and adjacent vessels as well as the aneurysmal sac were measured using a Conforma Micro-Doppler (Cook Vascular Inc., Leechburg, PA, USA). Pre- and post-operative cerebral angiography was obtained in all our patients. In 23 aneurysms (15.6%) there was decreased or absent flow in the parent vessel or in one of the adjacent vessels after clipping. In another 19 aneurysms (12.9%), MDU demonstrated flow through the aneurysmal dome even though the aneurysmal neck appeared to be totally obliterated. Presence of SAH, anatomic location and size of the aneurysm were associated with improper clip placement in a statistically significant fashion. The false positive rate for MDU was 2% while there were no false negative findings in our study. MDU appears to be a non-invasive, reliable alternative methodology to intra-operative angiography. This inexpensive method may lend itself to routine usage in aneurysm surgery.

KW - Aneurysm

KW - Improper clip placement

KW - Intraoperative ultrasound

KW - Micro-Doppler

KW - Partial occlusion

UR - http://www.scopus.com/inward/record.url?scp=37349121814&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37349121814&partnerID=8YFLogxK

U2 - 10.1016/j.jocn.2006.11.006

DO - 10.1016/j.jocn.2006.11.006

M3 - Article

VL - 15

SP - 153

EP - 157

JO - Journal of Clinical Neuroscience

JF - Journal of Clinical Neuroscience

SN - 0967-5868

IS - 2

ER -