The Power of Flow Measurement To Improve Pediatric Cerebrovascular Surgery

During pediatric cerebrovascular surgeries, the stakes couldn’t be higher. Every milliliter and every minute count. Precision truly is paramount for the patient, their loved ones, and the medical team caring for them.

Cerebrovascular diseases in children unfortunately are not rare. Cerebrovascular malformations, Moyamoya disease, aneurysms, and strokes are just some of the conditions specialists in leading hospitals manage with great skill and care.

Alongside these medical superheroes are other innovators in the field. Those conducting research, advancing surgical techniques and developing technologies to ensure the best possible outcomes for these children.

One of these leaps forward is flow measurements during cerebrovascular surgeries – also known as Flow Assisted Surgical Technique (FAST). With the right tools, FAST is available for adults, children, and infants.

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Measuring Flow for Pediatric Neurosurgery and Cerebrovascular Procedures

While many cerebrovascular diseases can be addressed with endovascular treatment, the most complex cases require neurosurgery. Intraoperative measurements take the guesswork out of blood flow assessments during these surgical procedures.

In each surgery, FAST uses transit-time ultrasound for intraoperative measurements. This provides surgeons the information they need at a critical moment.

Let’s look at an example.

FAST can be used during a variety of cerebrovascular procedures, including:

  • Aneurysm clipping surgery
  • Arterial EC-IC bypass surgery
  • Arteriovenous malformation (AVM) resection
  • Venous EC-IC bypass surgery
  • Spinal dural arteriovenous fistula occlusion
  • STA-MCA bypass for Moyamoya
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STA-MCA Bypass for Moyamoya

One strategy to alleviate the symptoms of Moyamoya disease is the surgical creation of an arterial extracranial to intracranial (EC-IC) bypass from the superficial temporal artery (STA) to the M4 middle cerebral artery branch.

During surgery, Transonic’s Charbel Micro-Flowprobe can be used to measure direct volume blood flow in the STA bypass and small target M4/MCA vessels.

  • Intraoperative blood flow measurements confirm the quality of the anastomosis and assure that the target area is receiving sufficient blood from the bypass.
  • Measurements also allow prompt revision if a technical error is suspected.

The Right Fit for Every Patient, No Matter How Small

Children and babies are not just miniature adults. They have unique anatomy and physiology that must be accounted in every medical procedure, especially ones as delicate as cerebrovascular surgery.

That means having the best pediatric neurologists and cerebrovascular surgeons to treat these children. It also means having the right tools at hand during procedures.

Transonic’s flow measurement technology gives surgeons the tools needed for FAST for patients of all sizes. These tools include:

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Extracranial Charbel Micro-Flowprobes

(sizes 3mm, 4mm and 6 mm)
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Intracranial Charbel Micro-Flowprobes

(sizes 1.5mm, 2mm and 3mm)
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Microvascular Flowprobes MU-Series

(the smallest clinical flowprobes on the market, down to size 0.7 mm)
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AureFlo

Oftentime, neurosurgeons only have access to a regular Doppler flowprobe, which is somewhat subjective because you can only listen to the sound of the flow with the Doppler probe.

The Charbel Micro-Flowprobe gives you a volumetric measurement in milliliters per minute which is much more of an objective measurement rather than a subjective sound that you are relying on.

The measurement that you get is much more accurate and the accuracy results in better outcomes for the surgery.”

– Dr. Sophia Shakur, Cerebrovascular Neurosurgeon at Peninsula Regional Medical Center in Salisbury, Maryland

Browse more resources about optimizing care for pediatric patients during cerebrovascular procedures:

ebook

Flow-Assisted Surgical Technique (F•A•S•T) in Cerebrovascular Surgery

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Benefits of FAST in Six Types of Surgery

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EC-IC Bypass (Moyamoya STA-M4MCA Revascularization) - Intraoperative Blood Flow Measurement

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Bypass Surgeries in Intracranial Vascular Diseases: Indications and Techniques via The Moroccan Society of Neurosurgery