Published in: Cancers
Authors: Jose Pedro Lavrador, Oliver Wroe-Wright, Francesco Marchi, Ali Elhag, Andrew O’Keeffe, Pablo De La Fuente, Christos Soumpasis, Andrea Cardia, Ana Mirallave Pescador, Alba Diaz-Bahamonde, Jose Sadio Mosquera, Domingos Coteiro, Sharon Jewell, Anthony J Strong, Richard Gullan, Keyoumars Ashkan, Francesco Vergani, Ahilan Kailaya-Vasan, Ranjeev S Bhango.
Year: 2025
Publication details: 17(9):1392
DOI: 10.3390/cancers17091392
Publication type: Journal article
Topic: Brain tumour surgery, minimally invasive neurosurgery, intraoperative imaging

Simple summary

This publication focuses on brain surgery for deep-seated brain tumours and looks at changes in small blood vessels on the surface of the brain during minimally invasive surgical approaches. It is relevant to intraoperative monitoring, surgical planning and the use of imaging during complex neurosurgical procedures.

Mr Kailaya-Vasan’s involvement

Mr Kailaya-Vasan, consultant neurosurgeon and neurovascular surgeon, is listed as a contributing author on this publication.

Published abstract

The following abstract is reproduced from the original publication and is provided for reference. It may include technical terminology intended for clinical or academic audiences.

The tubular retractor-assisted minimally invasive parafascicular approach (trMIPS) is a transsulcal approach to deep-seated brain tumours. It is a safe surgical approach but its impact on the microvascular dynamics of the retracted cortex and its clinical implications are unknown. Methods: This was a single-centre prospective study including patients with deep-seated brain tumours operated on with a trMIPS (BrainPath Nico System©). All patients underwent pre- and post-cannulation indocyanine green study using a FLOW 800 module in a KINEVO Zeiss© microscope. Speed, delay, time-to-peak (TtP) rise-in-time and cerebral blood flow index (CBFI) metrics were assessed. Results: Thirty-five patients were included, with 144 regions-of-interest (ROIs) selected. The majority of patients were diagnosed with glioblastoma (51.43%), and 37.14% of patients had a preoperative focal neurological deficit (FND) at presentation. A ROI-based analysis concluded that an increase in speed and CBFI was related with a worse neurological outcome when comparing the pre- and post-brain cannulation assessments (speed: deterioration = 43.12 ± 80.60% versus stable = −14.51 ± 57.80% versus improvement = 6.93 ± 31.33%, p < 0.0001; CBFI: deterioration = 50.40 ± 88.17% versus stable = −2.70 ± 67.54% versus improvement = −38.98 ± 26.17%, p = 0.0005). These findings were reproducible in a combined-ROI per patient analysis and confirmed after adjustment for confounding. Conclusion: Microvascular flow dynamics impact trMIPS outcomes as an increase in the speed and CBFI after decannulation was related with worse neurological outcome.

View Original Publication

Disclaimer

This publication page is provided for general information about Mr Kailaya-Vasan’s academic work. It is not medical advice and should not be used to guide individual diagnosis or treatment decisions. Patients should discuss their individual symptoms, diagnosis and treatment options with a specialist.