{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T19:56:44Z","timestamp":1776455804644,"version":"3.51.2"},"reference-count":54,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The tubular retractor-assisted minimally invasive parafascicular approach (trMIPS) is a transsulcal approach to deep-seated brain tumours. It is a safe surgical approach but its impact on the microvascular dynamics of the retracted cortex and its clinical implications are unknown. Methods: This was a single-centre prospective study including patients with deep-seated brain tumours operated on with a trMIPS (BrainPath Nico System\u00a9). All patients underwent pre- and post-cannulation indocyanine green study using a FLOW 800 module in a KINEVO Zeiss\u00a9 microscope. Speed, delay, time-to-peak (TtP) rise-in-time and cerebral blood flow index (CBFI) metrics were assessed. Results: Thirty-five patients were included, with 144 regions-of-interest (ROIs) selected. The majority of patients were diagnosed with glioblastoma (51.43%), and 37.14% of patients had a preoperative focal neurological deficit (FND) at presentation. A ROI-based analysis concluded that an increase in speed and CBFI was related with a worse neurological outcome when comparing the pre- and post-brain cannulation assessments (speed: deterioration = 43.12 \u00b1 80.60% versus stable = \u221214.51 \u00b1 57.80% versus improvement = 6.93 \u00b1 31.33%, p &lt; 0.0001; CBFI: deterioration = 50.40 \u00b1 88.17% versus stable = \u22122.70 \u00b1 67.54% versus improvement = \u221238.98 \u00b1 26.17%, p = 0.0005). These findings were reproducible in a combined-ROI per patient analysis and confirmed after adjustment for confounding. Conclusion: Microvascular flow dynamics impact trMIPS outcomes as an increase in the speed and CBFI after decannulation was related with worse neurological outcome.<\/jats:p>","DOI":"10.3390\/cancers17091392","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T20:11:48Z","timestamp":1745352708000},"page":"1392","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Microvascular Cortical Dynamics in Minimal Invasive Deep-Seated Brain Tumour Surgery"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9518-111X","authenticated-orcid":false,"given":"Jos\u00e9 Pedro","family":"Lavrador","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Wroe-Wright","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6532-7168","authenticated-orcid":false,"given":"Francesco","family":"Marchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"},{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Elhag","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"O\u2019Keeffe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"De La Fuente","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Araba University Hospital, 01009 Vitoria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Soumpasis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7349-3753","authenticated-orcid":false,"given":"Andrea","family":"Cardia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Mirallave-Pescador","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"},{"name":"Department of Neurophysiology, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1256-516X","authenticated-orcid":false,"given":"Alba","family":"D\u00edaz-Baamonde","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"},{"name":"Department of Neurophysiology, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Sadio","family":"Mosquera","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"},{"name":"Department of Neurophysiology, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8955-8533","authenticated-orcid":false,"given":"Domingos","family":"Coiteiro","sequence":"additional","affiliation":[{"name":"Unidade de Saude Local, Hospital Santa Maria, 1649-028 Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Jewell","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College University, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Strong","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College University, London WC2R 2LS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Gullan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keyoumars","family":"Ashkan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Vergani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahilan Kailaya","family":"Vasan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjeev","family":"Bhangoo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital Foundation Trust, London SE5 9RS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1093\/neuonc\/noac255","article-title":"Impact of maximal extent of resection on postoperative deficits, patient functioning, and survival within clinically important glioblastoma subgroups","volume":"25","author":"Gerritsen","year":"2023","journal-title":"Neuro. 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