METHOD OF SELECTIVE EXTRA-INTRACRANIAL HYPO-PERFUSION PERFORMING IN THE REGION OF HYPO-PERFUSION WITH THE USE OF NEURONAVIGATION Russian patent published in 2018 - IPC A61B17/22 A61B6/03 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely to neurosurgery, radiation diagnostics, and can be used in performing selective extra-intracranial microanastomosis in the hypoperfusion region using neuronavigation. At the pre-surgery stage, CT angiography of the extra- and intracranial arteries and SPECT of the brain are performed. On the SPECT of the brain, a hypoperfusion zone with blood flow values less than 38 ml/min/100 g is detected. By sequentially contouring the above-described zone, a 3D model of the hypoperfusion zone on all axial sections is created. In the navigation station, SPECT and CT angiography are combined in one dialog box. At each section, intracranial recipient artery image is contoured. Recipient artery should be in the area of low blood supply and have a diameter of 0.8–1.0 mm. Also on the image, outlining up to three potential arteries-donors from the pool of the external carotid artery with a thickness of up to 1.0–1.5 mm and a length of at least 6 cm. Donor arteries should be in the projection of the recipient artery, for this, on a 3D model of marked donor arteries selecting an artery located as close as possible to the source of low-blood supply, having a diameter equal to or greater than the diameter of the recipient artery, and located at a distance from the recipient artery of no more than 1–3 cm. Then craniotomy is simulated, for which a region of 2–4 cm in diameter is selected on the 3D model, which center is the intersection of the recipient artery projection to the chosen donor artery. In the surgery room environment using frameless neuronavigation, the skin orientations are compared with the received data on the 3D model and arteries and surgical access marking is performed. Trepanation in the projection of the region of hypoperfusion is carried out, followed by the imposition of extra-intracranial microanastomosis between the desired arteries.

EFFECT: method provides the possibility of selective revascularization of the desired region of the brain with high accuracy to improve perfusion and functional outcomes after acute cerebrovascular accident suffering in patients with the internal carotid artery occlusion.

1 cl, 10 dwg, 1 ex