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Konovalov A, Grebenev F, Stavtsev D, Kozlov I, Gadjiagaev V, Piavchenko G, Telyshev D, Gerasimenko AY, Meglinski I, Zalogin S, Artemyev A, Golodnev G, Shumeiko T, Eliava S. Real-time laser speckle contrast imaging for intraoperative neurovascular blood flow assessment: animal experimental study. Sci Rep 2024; 14:1735. [PMID: 38242903 PMCID: PMC10799050 DOI: 10.1038/s41598-023-51022-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/29/2023] [Indexed: 01/21/2024] Open
Abstract
The use of various blood flow control methods in neurovascular interventions is crucial for reducing postoperative complications. Neurosurgeons worldwide use different methods, such as contact Dopplerography, intraoperative indocyanine videoangiography (ICG) video angiography, fluorescein angiography, flowmetry, intraoperative angiography, and direct angiography. However, there is no noninvasive method that can assess the presence of blood flow in the vessels of the brain without the introduction of fluorescent substances throughout the intervention. The real-time laser-speckle contrast imaging (LSCI) method was studied for its effectiveness in controlling blood flow in standard cerebrovascular surgery cases in rat common carotid arteries, such as proximal occlusion, trapping, reperfusion, anastomosis, and intraoperative vessel thrombosis. The real-time LSCI method is a promising method for use in neurosurgical practice. This approach allows timely diagnosis of intraoperative disturbance of blood flow in vessels in cases of clip occlusion or thrombosis. Additionally, LSCI allows us to reliably confirm the functioning of the anastomosis and reperfusion after removal of the clips and thrombolysis in real time. An unresolved limitation of the method is noise from movements, but this does not reduce the value of the method. Additional research is required to improve the quality of the data obtained.
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Affiliation(s)
- Anton Konovalov
- Burdenko Neurosurgшcal Center, Moscow, Russian Federation.
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation.
| | - Fyodor Grebenev
- Burdenko Neurosurgшcal Center, Moscow, Russian Federation
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation
| | - Dmitry Stavtsev
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation
- Institute of Biomedical Systems, National Research University of Electronic Technology, Zelenograd, Moscow, 124498, Russian Federation
| | - Igor Kozlov
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation
| | | | - Gennadii Piavchenko
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Dmitry Telyshev
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation
- Institute of Biomedical Systems, National Research University of Electronic Technology, Zelenograd, Moscow, 124498, Russian Federation
| | - Alexander Yu Gerasimenko
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russian Federation
- Institute of Biomedical Systems, National Research University of Electronic Technology, Zelenograd, Moscow, 124498, Russian Federation
| | - Igor Meglinski
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
- College of Engineering and Physical Sciences, Aston University, Birmingham, UK.
| | - Savely Zalogin
- Department of Operative Surgery and Topographic Anatomy, I.M, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anton Artemyev
- Department of Operative Surgery and Topographic Anatomy, I.M, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Grigorii Golodnev
- Department of Operative Surgery and Topographic Anatomy, I.M, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Tatiana Shumeiko
- Department of Operative Surgery and Topographic Anatomy, I.M, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Shalva Eliava
- Burdenko Neurosurgшcal Center, Moscow, Russian Federation
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Konovalov A, Grebenev F, Savinkov R, Grebennikov D, Zheltkova V, Bocharov G, Telyshev D, Eliava S. Mathematical analysis of the effectiveness of screening for intracranial aneurysms in first-degree relatives of persons with SAH. World Neurosurg 2023:S1878-8750(23)00462-X. [PMID: 37087036 DOI: 10.1016/j.wneu.2023.03.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/24/2023]
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Konovalov A, Tlisova M, Gadzhiagaev V, Grebenev F, Safronova E. "Unshaved Intradermal Running Suture for Elective Cranial Neurovascular Surgeries". World Neurosurg 2023; 171:139-143. [PMID: 36608797 DOI: 10.1016/j.wneu.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/01/2023] [Indexed: 01/05/2023]
Abstract
OBJECTIVE In this paper, we analyze the experience and propose a method of incision and stitching of the postoperative scalp wound without shaving hair in elective neurosurgical interventions. METHODS Between January 2021 and May 2022, 44 patients with various neurovascular pathologies were included in the study. The age of the patients varied from 28 to 58 years. All patients underwent elective surgical interventions with intradermal cosmetic sutures without shaving hair. The results of published observational series of neurosurgical patients with unshaved hair were also analyzed. RESULTS Treatment of the surgical field, scalp, and incision were performed without shaving hair in 44 cases. The technique of intradermal suture without shaving hair was used in 31 cases of the classical pterional approach, in 11 cases of minipteronal, in 1 case of parasagittal, and in 1 case of retrosigmoid suboccipittal approaches. The mean age of the patients was 47.5 years (±8.82). The average length of stay in the clinic was 8.02 days (±2.04). The sutures were removed on the fifth-eighth day. All cases were operated on for elective neurovascular interventions: aneurysms without rupture (95.4%), arteriovenous malformations (2.3%), and cavernous angiomas (2.3%). All but one patient (2.3%) had no wound complications-the suture ruptured at the stage of its removal from the skin. CONCLUSIONS Our results also show that the use of a nonresorbable intradermal suture combined with hair preservation does not affect the risk of infection.
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Affiliation(s)
- Anton Konovalov
- Department of Cerebrovascular Surgery, Burdenko Neurosurgical Center, Moscow, Russia.
| | - Mariana Tlisova
- Department of Craniofacial Neurosurgery, Burdenko Neurosurgical Center, Moscow, Russia
| | - Vadim Gadzhiagaev
- Department of Cerebrovascular Surgery, Burdenko Neurosurgical Center, Moscow, Russia
| | - Fyodor Grebenev
- Department of Cerebrovascular Surgery, Burdenko Neurosurgical Center, Moscow, Russia
| | - Elizaveta Safronova
- Department of Pediatric Neurosurgery, Burdenko Neurosurgical Center, Moscow, Russia
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Konovalov A, Gadzhiagaev V, Grebenev F, Stavtsev D, Piavchenko G, Gerasimenko A, Telyshev D, Meglinski I, Eliava S. Laser Speckle Contrast Imaging in Neurosurgery: A Systematic Review. World Neurosurg 2023; 171:35-40. [PMID: 36526222 DOI: 10.1016/j.wneu.2022.12.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Intraoperative study of blood flow in the brain vessels is among the most critical topics of modern neurosurgery. One of the promising methods for intraoperative monitoring of blood flow is laser speckle contrast imaging (LSCI). This systematic review aims to analyze the experience of using intraoperative LSCI in neurosurgical interventions. METHODS The literature search was carried out in the PubMed and Web of Science databases using the keywords "Laser-Speckle," "Laser Speckle," "Laser speckle contrast imaging," and "LSCI." We allowed the search to include the following criteria: 1) publication in the English language, 2) full access to the article, 3) information about the method of treatment, and 4) the results presented for at least one patient. RESULTS The initial search resulted in the detection of 508 publications, of which 476 were eliminated during the initial assessment of titles and abstracts. Two more articles were excluded due to the lack of data in the English language. Twenty articles were found to be focused on nonhuman studies and therefore were excluded. In three more studies treatment of non-neurosurgical patients was reported. The final analysis included 8 articles with 102 patients overall. CONCLUSIONS LSCI is a promising intraoperative method for intraoperative cerebral blood flow assessing. This method offers several advantages over other modalities. The experience of use is limited to a small number of case series. Further investigation of the method and its implementation in clinical practice is needed.
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Affiliation(s)
- Anton Konovalov
- Department of Cerebrovascular Surgery, Burdenko Neurosurgical Center, Moscow, Russian Federation.
| | - Vadim Gadzhiagaev
- Department of Cerebrovascular Surgery, Burdenko Neurosurgical Center, Moscow, Russian Federation
| | - Fyodor Grebenev
- Department of Cerebrovascular Surgery, Burdenko Neurosurgical Center, Moscow, Russian Federation
| | - Dmitry Stavtsev
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; National Research University of Electronic Technology, Institute of Biomedical Systems, Moscow, Russia
| | - Gennadii Piavchenko
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alexander Gerasimenko
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; National Research University of Electronic Technology, Institute of Biomedical Systems, Moscow, Russia
| | - Dmitry Telyshev
- Institute for Bionic Technologies and Engineering, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; National Research University of Electronic Technology, Institute of Biomedical Systems, Moscow, Russia
| | - Igor Meglinski
- Opto-Electronics and Measurement Techniques, Faculty of Information and Electrical Engineering, University of Oulu, Oulu, Finland; College of Engineering and Physical Sciences, Aston University, Birmingham, UK
| | - Shalva Eliava
- Department of Cerebrovascular Surgery, Burdenko Neurosurgical Center, Moscow, Russian Federation
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Konovalov A, Grebenev F, Asyutin D, Zakirov B, Konovalov N, Pronin I, Eliava S, Chaurasia B. Spinal dural cerebrospinal fluid fistula as a cause of spontaneous intracranial hypotension syndrome: Diagnosis and surgical treatment. J Craniovertebr Junction Spine 2023; 14:108-112. [PMID: 37213575 PMCID: PMC10198209 DOI: 10.4103/jcvjs.jcvjs_135_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023] Open
Abstract
Spontaneous intracranial hypotension (SIH) syndrome most often occurs following a cerebrospinal fluid (CSF) fistula that develops in the spinal space. Neurologists and neurosurgeons lack an understanding of the pathophysiology and diagnosis of this disease, which can make timely surgical care difficult. With the correct diagnostic algorithm, it is possible to identify the exact location of the liquor fistula in 90% of cases; subsequent microsurgical treatment can save the patient from the symptoms of intracranial hypotension and restore the ability to work. Female patient, 57 years old, was admitted with SIH syndrome. Magnetic resonance imaging (MRI) of the brain with contrast confirmed signs of intracranial hypotension. Computed tomography (CT) myelography was performed to pinpoint the location of the CSF fistula. The diagnostic algorithm and successful microsurgical treatment of a patient with spinal dural CSF fistula at the Th3-4 level using a posterolateral transdural approach. The patient was discharged on day 3 after the surgery when these complaints regressed completely. At the control examination of the patient 4 months postoperatively, there were no complaints. Identification of the cause and location of spinal the CSF fistula is a complex process that requires several stages of diagnosis. Examination of the entire back with MRI, CT myelography, or subtraction dynamic myelography is recommended. Microsurgical repair of a spinal fistula is an effective method for the treatment of SIH. The posterolateral transdural approach is effective in the repair of a spinal CSF fistula located ventrally in the thoracic spine.
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Affiliation(s)
| | | | | | | | | | - Igor Pronin
- Burdenko Neurosurgical Center, Moscow, Russia
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Ishankulov T, Grebenev F, Strunina U, Shekhtman O, Eliava S, Danilov G. The Prediction of Functional Outcome After Microsurgical Treatment of Unruptured Intracranial Aneurysm Based on Machine Learning. Stud Health Technol Inform 2022; 294:470-474. [PMID: 35612124 DOI: 10.3233/shti220503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Our study aimed to create a machine learning model to predict patients' functional outcomes after microsurgical treatment of unruptured intracranial aneurysms (UIA). Data on 615 microsurgically treated patients with UIA were collected retrospectively from the Electronic Health Records at N.N. Burdenko Neurosurgery Center (Moscow, Russia). The dichotomized modified Rankin Scale (mRS) at the discharge was used as a target variable. Several machine learning models were utilized: a random forest upon decision trees (RF), logistic regression (LR), support vector machine (SVM). The best result with F1-score metric = 0.904 was produced by the SVM model with a label-encode method. The predictive modeling based on machine learning might be promising as a decision support tool in intracranial aneurysm surgery.
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Affiliation(s)
- Timur Ishankulov
- National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Fyodor Grebenev
- National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Uliya Strunina
- National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Oleg Shekhtman
- National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Shalva Eliava
- National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
| | - Gleb Danilov
- National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russian Federation
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