Intraoperative Fluorescence Cerebral Angiography by Laser Surgical Microscopy: Comparison With Xenon Microscopy and Simultaneous Observation of Cerebral Blood Flow and Surrounding Structures.
BACKGROUND
Laser surgical microscopes should enable uniform illumination of the operative field, and require less luminous energy compared with existing xenon surgical microscopes.


OBJECTIVE
To examine the utility of laser illumination in fluorescence cerebral angiography.


METHODS
Fluorescein sodium (fluorescein) was used as a fluorescent dye. We first compared the clarity of cerebral blood flow images collected by fluorescence angiography between the laser illumination and xenon illumination methods. We then assessed use of the laser illuminator for simultaneous observation of blood flow and surrounding structures during fluorescence angiography. Furthermore, the study was designed to evaluate usefulness of the thus determined excitation light in clinical cases.


RESULTS
Fluorescence angiography using blue light laser for excitation provided higher clarity and contrast blood flow images compared with using blue light generated from a xenon lamp. Further, illumination with excitation light consisting of a combination of 3 types of laser (higher level of blue light, no green light, and lower level of red light) enabled both blood flow and surrounding structures to be observed through the microscope directly by the surgeon.


CONCLUSION
Laser-illuminated fluorescence angiography provides high clarity and contrast images of cerebral blood flow. Further, a laser providing strong blue light and weak red light for excitation light enables simultaneous visual observation of fluorescent blood flow and surrounding structures by the surgeon using a surgical microscope. Overall, these data suggest that laser surgical microscopes are useful for both ordinary operative manipulations and fluorescence angiography.
['Ito|Yuhei|Y|', 'Suzuki|Kyouichi|K|', 'Ichikawa|Tsuyoshi|T|', 'Watanabe|Yoichi|Y|', 'Sato|Taku|T|', 'Sakuma|Jun|J|', 'Saito|Kiyoshi|K|']
D000368:Aged D001706:Biopsy D002533:Cerebral Angiography D002560:Cerebrovascular Circulation D000072226:Computed Tomography Angiography D005260:Female D019793:Fluorescein D005451:Fluorescein Angiography D005456:Fluorescent Dyes D006801:Humans D002532:Intracranial Aneurysm D007430:Intraoperative Care D008853:Microscopy D018613:Microscopy, Confocal D008875:Middle Aged D019635:Neurosurgical Procedures D020293:Vasculitis, Central Nervous System D014978:Xenon
Surgical microscope Fluorescence angiography Laser light