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J Neurosurg. 2006 Sep;105(3):406-11.

Three-dimensional rotational angiography guidance for aneurysm surgery.

Author information

1
Department of Neurosurgery, Johann Wolfgang Goethe-Universit├Ąt, Frankfurt am Main, Germany. A.Raabe@em.uni-frankfurt.de

Abstract

OBJECT:

The aim of this study was to investigate the feasibility of integrating three-dimensional rotational angiography (3D-RA) data into a surgical navigation system and to assess its accuracy and potential clinical benefit.

METHODS:

The study cohort consisted of 16 patients with 16 intracranial aneurysms who had been scheduled for routine or emergency surgery. Rotational angiography data were exported using a virtual reality modeling language file format and imported into the BrainLAB VectorVision2 image-guided surgery equipment. During 3D-RA the position of the head was measured using a special headframe. The authors also determined the accuracy of 3D-RA image guidance and the clinical benefit as judged by the surgeon, including, for example, early identification of branching vessels and the aneurysm. There was good correspondence between the 3D-RA-based navigation data and the intraoperative vascular anatomy in all cases, with a maximum error of 9 degrees of angulation and 9 degrees of rotation. In eight cases, the surgeon determined that the 3D-RA image guidance facilitated the surgical procedure by predicting the location of the aneurysm or the origin of a branching artery that had been covered by brain tissue and blood clots.

CONCLUSIONS:

The integration of 3D-RA into surgical navigation systems is feasible, but it currently requires a new perspective-registration technique. The intraoperative 3D view provides useful information about the vascular anatomy and may improve the quality of aneurysm surgery in selected cases.

PMID:
16961135
DOI:
10.3171/jns.2006.105.3.406
[Indexed for MEDLINE]

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