TY - JOUR
T1 - Preoperative endovascular brain mapping for intraoperative volumetric image guidance
T2 - Preliminary concept and feasibility in animal models
AU - Mericle, Robert A.
AU - Richter, Erich O.
AU - Eskioglu, Eric
AU - Watkins, Courtney
AU - Prokai, Laszlo
AU - Batich, Christopher
AU - Santra, Swadeshmukul
PY - 2006/4/1
Y1 - 2006/4/1
N2 - Object. The authors describe a novel concept for brain mapping in which an endovascular approach is used, and they demonstrate its feasibility in animal models. The purpose of endovascular brain mapping is to delineate clearly the nonfunctional brain parenchyma when a craniotomy is performed for resection. The nonfunctional brain will be stained with sharp visual margins, differentiating it from the functional, nonstained brain. The authors list four essential criteria for developing an ideal endovascular mapping agent, and they describe seven potential approaches for accomplishing a successful endovascular brain map. Methods. Four Sprague-Dawley rats and one New Zealand white rabbit were used to determine initial feasibility of the procedure. The animals were anesthetized, and the internal carotid artery was catheterized. Four potential brain mapping agents were infused into the right hemisphere of the five animals. Afterward, the brains were removed and each was analyzed both grossly and histologically. Fluorescein and FD&C Green No. 3 provided good visual clarity and margins, but required blood-brain barrier (BBB) manipulation. Tantalum particles enabled avoidance of BBB manipulation, but provided inadequate visual clarity, probably because of their size. A Sudan black "cocktail" provided excellent clarity and margins despite remaining in the brain capillaries. Conclusions. This is a novel application of the endovascular approach, and has broad potential for clinical neurosurgical brain mapping. The animal models in this study establish the feasibility of the procedure. However, further study is required to demonstrate safety, minimize toxicity, investigate stain durability, and improve the characteristics of potential mapping agents. The authors are planning to conduct future studies for identification of mapping agents that do not require BBB manipulation or vascular occlusion.
AB - Object. The authors describe a novel concept for brain mapping in which an endovascular approach is used, and they demonstrate its feasibility in animal models. The purpose of endovascular brain mapping is to delineate clearly the nonfunctional brain parenchyma when a craniotomy is performed for resection. The nonfunctional brain will be stained with sharp visual margins, differentiating it from the functional, nonstained brain. The authors list four essential criteria for developing an ideal endovascular mapping agent, and they describe seven potential approaches for accomplishing a successful endovascular brain map. Methods. Four Sprague-Dawley rats and one New Zealand white rabbit were used to determine initial feasibility of the procedure. The animals were anesthetized, and the internal carotid artery was catheterized. Four potential brain mapping agents were infused into the right hemisphere of the five animals. Afterward, the brains were removed and each was analyzed both grossly and histologically. Fluorescein and FD&C Green No. 3 provided good visual clarity and margins, but required blood-brain barrier (BBB) manipulation. Tantalum particles enabled avoidance of BBB manipulation, but provided inadequate visual clarity, probably because of their size. A Sudan black "cocktail" provided excellent clarity and margins despite remaining in the brain capillaries. Conclusions. This is a novel application of the endovascular approach, and has broad potential for clinical neurosurgical brain mapping. The animal models in this study establish the feasibility of the procedure. However, further study is required to demonstrate safety, minimize toxicity, investigate stain durability, and improve the characteristics of potential mapping agents. The authors are planning to conduct future studies for identification of mapping agents that do not require BBB manipulation or vascular occlusion.
KW - Embolization
KW - Endovascular brain mapping
KW - Functional stereotactic neurosurgery
KW - Glioblastoma multiforme
KW - Rabbit
KW - Rat
KW - Wada test
UR - http://www.scopus.com/inward/record.url?scp=33645536259&partnerID=8YFLogxK
U2 - 10.3171/jns.2006.104.4.566
DO - 10.3171/jns.2006.104.4.566
M3 - Article
C2 - 16619661
AN - SCOPUS:33645536259
SN - 0022-3085
VL - 104
SP - 566
EP - 573
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
IS - 4
ER -