[Strategy for assisted cerebral arteriovenous malformation surgery].

OBJECTIVE

To evaluate the surgical effects of such adjuvant techniques as type B ultrasound, neuronavigation and intraoperative indocyanine green video-angiography (ICGA) on intracranial arteriovenous malformation (AVM) surgery.

METHODS

From January to October 2009, 43 AVM patients treated at our center were retrospectively studied, including 26 males and 17 females with an age range of 8 to 53 years old (mean: 26.51). Type B ultrasound, neuronavigation or ICGA were employed during surgical procedures in all cases. Intraoperative findings were compared with those of postoperative digital subtraction angiography (DSA) or computed tomography angiography (CTA). And the clinical outcomes were evaluated.

RESULTS

As confirmed by postoperative DSA or CTA, the lesions of all 43 patients were totally removed. Only 3 patients (7.0%) suffered from new neurological deficits, including homonymous hemianopia in 2 patients and diplopia in 1. And the Karnofsky performance scale was higher than 80 for each patient.

CONCLUSION

The feeding arteries and draining veins can be differentiated by intraoperative type B ultrasound, neuronavigation and ICGA. All three adjuvant techniques can define the lesion boundary. However, each of them has its own benefits and drawbacks. It indicates that the combination of two or more techniques may help to improve the quality and outcome of surgical procedures.