Advances in cerebrovascular neurosurgery real-time, intraoperative, non-invasive monitoring of cerebral blood flow
Introduction: Cerebrovascular surgery requires an intraoperative system to conduct continuous monitoring of the cerebral blood flow (CBF). To assist with neurosurgical maneuvers, such a system must be handy, non-invasive, and directly integrated into the surgical workflow. None of the currently available techniques, considered alone, meets all these criteria. Here, we introduce the SurgeON™ system, a newly developed non-invasive modular tool which transmits high-resolution Laser Speckle Contrast Imaging (LSCI) directly onto the eyepiece of the surgical microscope.
Results: This study, performed in rat models of femoral arteries and rabbit models of brain cortical vessels, shows that the SurgeON™ system efficiently displays a real-time view of changes in blood flow (BF) and CBF across multiple vessels of different size and across different surgical fields. Additionally, in rat models of middle cerebral artery occlusion (MCAo) and rabbit models of brain cortical vessels cautery, we compared our system with indocyanine green angiography videoangiography (ICG-VA) imaging, also operable via the SurgeON™ system, and found that direct-LSCI can provide greater information than ICG-VA and that the continuous display of information it provides is advantageous for performing immediate LSCI-guided adjustments in real time during surgical maneuvers.