{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:44:42Z","timestamp":1786124682980,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T00:00:00Z","timestamp":1528761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Revascularization strategies for complex cerebral aneurysms are largely based on subjective interpretation of flow demands, or indirect measures of perfusion in at-risk territories. Indocyanine Green -based flow analyses ((ICG-BFA); Flow 800, Carl Zeiss, Oberkochen, Germany) provide a real-time, semiquantitative measure of intraoperative cortical perfusion during cerebral bypass surgery for complex aneurysms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To determine the utility of intraoperative ICG-BFA for assessing cortical perfusion in at-risk territories during cerebral bypass for complex aneurysms requiring vessel sacrifice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Retrospective analysis of consecutive patients from a prospective, single-institution open cerebrovascular database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Intraoperative ICG-BFA confirmed adequate cortical perfusion in 2 patients with fusiform posterior circulation aneurysms, treated with a posterior inferior cerebellar artery (PICA)-PICA and occipital artery (OA)-to-third segment of the posterior cerebral artery (P3) bypass with proximal vessel sacrifice, respectively. ICG-BFA was used in a third patient that underwent clip reconstruction\/ intracranial-to-intracranial bypass for a large middle cerebral artery (MCA) bifurcation aneurysm requiring sacrifice of the temporal M2 branch. In this case, a frontal M3 to temporal M3 side-to-side anastomosis was created to arborize the MCA tree and allow filling of both M2 territories through a single M2 branch. After aneurysm reconstruction, ICG-BFA identified an inadvertent occlusion of the frontal M2 that left the entire MCA distribution reliant on collateral flow but did not cause a neuromonitoring change. Repeat ICG-BFA after clip re-arrangement demonstrated aneurysm occlusion and equal flow in both frontal and temporal MCA cortical distributions from the arborization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>ICG-BFA is a useful adjunct for intraoperative cortical flow assessment during cerebral revascularization for complex aneurysms requiring vessel sacrifice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy154","type":"journal-article","created":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T06:07:45Z","timestamp":1528783665000},"page":"583-592","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Intraoperative Assessment of Cortical Perfusion After Intracranial-To-Intracranial and Extracranial-To-Intracranial Bypass for Complex Cerebral Aneurysms Using Flow 800"],"prefix":"10.1227","volume":"16","author":[{"given":"Robert C","family":"Rennert","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben A","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Ravina","sequence":"additional","affiliation":[{"name":"Neurorestoration Center, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bakhsheshian","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vance","family":"Fredrickson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J","family":"Russin","sequence":"additional","affiliation":[{"name":"Neurorestoration Center, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,5]]},"reference":[{"issue":"4","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1227\/01.NEU.0000348557.11968.F1","volume":"65","author":"Sanai","year":"2009","journal-title":"Neurosurgery"},{"issue":"4","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"224","DOI":"10.14797\/mdcj-10-4-224","article-title":"Bypasses and reconstruction for complex brain aneurysms","volume":"10","author":"da Silva","year":"2014","journal-title":"Methodist DeBakey Cardiovas J"},{"issue":"2","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.jocn.2011.12.038","article-title":"Uses and limitations of indocyanine green videoangiography for flow analysis in arteriovenous malformation surgery","volume":"20","author":"Ng","year":"2013","journal-title":"J Clin Neurosci"},{"issue":"11","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1016\/j.jocn.2011.01.041","article-title":"FLOW 800-assisted surgery for arteriovenous malformation","volume":"18","author":"Jhawar","year":"2011","journal-title":"J Clin Neurosci"},{"issue":"6","key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"829","DOI":"10.4103\/0028-3886.91359","article-title":"Preliminary evaluation of the role of surgical microscope-integrated intraoperative FLOW 800 colored indocyanine fluorescence angiography in arteriovenous malformation surgery","volume":"59","author":"Kato","year":"2011","journal-title":"Neurol India"},{"issue":"3","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1227\/01.NEU.0000346649.48114.3A","article-title":"Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green angiography during cerebral arteriovenous malformation surgery","volume":"65","author":"Killory","year":"2009","journal-title":"Neurosurgery"},{"issue":"22","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"4232","DOI":"10.3760\/cma.j.issn.0366-6999.20131649","article-title":"Clinical values of intraoperative indocyanine green fluorescence video angiography with Flow 800 software in cerebrovascular surgery","volume":"126","author":"Ye","year":"2013","journal-title":"Chin Med J (Engl)"},{"issue":"9","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1007\/s00701-014-2161-2","article-title":"Intraoperative assessment of cortical perfusion by indocyanine green videoangiography in surgical revascularization for moyamoya disease","volume":"156","author":"Uchino","year":"2014","journal-title":"Acta Neurochir"},{"issue":"4","key":"bib9-20240909","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s00701-012-1575-y","article-title":"Semiquantitative analysis of indocyanine green videoangiography for cortical perfusion assessment in superficial temporal artery to middle cerebral artery anastomosis","volume":"155","author":"Uchino","year":"2013","journal-title":"Acta Neurochir"},{"issue":"Suppl 2","key":"bib10-20240909","first-page":"231","article-title":"FLOW 800 allows visualization of hemodynamic changes after extracranial-to-intracranial bypass surgery but not assessment of quantitative perfusion or flow","volume":"10","author":"Prinz","year":"2014","journal-title":"Neurosurgery"},{"issue":"5","key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.3171\/2016.11.JNS162403","article-title":"Correlation between reduction in microvascular transit time after superficial temporal artery-middle cerebral artery bypass surgery for moyamoya disease and the development of postoperative hyperperfusion syndrome","volume":"128","author":"Yang","year":"2018","journal-title":"J Neurosurg"},{"issue":"1","key":"bib12-20240909","doi-asserted-by":"crossref","first-page":"135","DOI":"10.4103\/2152-7806.140705","article-title":"Quantitative cerebral perfusion assessment using microscope-integrated analysis of intraoperative indocyanine green fluorescence angiography versus positron emission tomography in superficial temporal artery to middle cerebral artery anastomosis","volume":"5","author":"Kobayashi","year":"2014","journal-title":"Surg Neurol Int"},{"key":"bib13-20240909","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.wneu.2017.01.009","article-title":"Sensitivity and specificity of intraoperative neuromonitoring for identifying safety and duration of temporary aneurysm clipping based on vascular territory, a multimodal strategy","volume":"100","author":"Staarmann","year":"2017","journal-title":"World Neurosurg"},{"issue":"2","key":"bib14-20240909","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1385\/NCC:2:2:141","article-title":"Effects of temporary clips on somatosensory evoked potentials in aneurysm surgery","volume":"2","author":"Schick","year":"2005","journal-title":"Neurocrit Care"},{"issue":"6","key":"bib15-20240909","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.3171\/jns.1999.91.6.1050","article-title":"Quantitative assessment of vessel flow integrity for aneurysm surgery. Technical note","volume":"91","author":"Charbel","year":"1999","journal-title":"J Neurosurg"},{"issue":"2a","key":"bib16-20240909","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1590\/S0004-282X2005000200028","article-title":"Clip readjustment in aneurysm surgery after flow evaluation using the ultrasonic perivascular probe: case report","volume":"63","author":"Fagundes-Pereyra","year":"2005","journal-title":"Arq. Neuropsiquiatr"},{"issue":"4 Suppl 2","key":"bib17-20240909","first-page":"ONS-305-312","article-title":"The utility of intraoperative blood flow measurement during aneurysm surgery using an ultrasonic perivascular flow probe","volume":"58","author":"Amin-Hanjani","year":"2006","journal-title":"Neurosurgery"},{"issue":"6","key":"bib18-20240909","doi-asserted-by":"crossref","first-page":"993","DOI":"10.3171\/jns.2002.96.6.0993","article-title":"Intraoperative angiography during aneurysm surgery: a prospective evaluation of efficacy","volume":"96","author":"Tang","year":"2002","journal-title":"J Neurosurg"},{"issue":"5","key":"bib19-20240909","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.surneu.2009.01.027","article-title":"Microscope-integrated near-infrared indocyanine green videoangiography during surgery of intracranial aneurysms: the Helsinki experience","volume":"71","author":"Dashti","year":"2009","journal-title":"Surg Neurol"},{"issue":"1","key":"bib20-20240909","first-page":"132","article-title":"Near-infrared indocyanine green video angiography: a new method for intraoperative assessment of vascular flow","volume":"52","author":"Raabe","year":"2003","journal-title":"Neurosurgery"},{"issue":"2","key":"bib21-20240909","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s10143-010-0305-2","article-title":"Evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery","volume":"34","author":"Wang","year":"2011","journal-title":"Neurosurg Rev"},{"key":"bib22-20240909","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jocn.2017.01.026","article-title":"The arborization bypass: Sequential intracranial-intracranial bypasses for an unruptured fusiform MCA aneurysm","volume":"39","author":"Russin","year":"2017","journal-title":"J Clin Neurosci"},{"issue":"1","key":"bib23-20240909","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s10143-014-0571-5","article-title":"Management of complex intracranial aneurysms with bypass surgery: a technique application and experience in 93 patients","volume":"38","author":"Shi","year":"2015","journal-title":"Neurosurg Rev"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/16\/5\/583\/30214807\/opy154.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/01787389-201905000-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:44:13Z","timestamp":1786121053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01787389-201905000-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,12]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opy154","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,12]]},"assertion":[{"value":"2018-02-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}