High-tech microscope lights up brain for neurosurgeons

World-first technology now in use at University of Alberta Hospital

EDMONTON — Neurosurgeons at the University of Alberta Hospital are now able to instantly check the outcome of their work using a new, high-tech microscope that makes blood vessels in the brain light up like neon.

The technology allows doctors to verify that procedures to restore healthy blood flow are successful while still in the operating room, improving patient outcomes and reducing the need for followup surgeries to eliminate new leaks or blockages in blood vessels.

“We get a picture of the blood vessels that we’ve never had before. The blood vessels shine silvery white against a dark background, which gives us the security and knowledge right in the operating room that an aneurysm is completely gone, obliterated, and all the healthy blood vessels around it are left intact,” says neurosurgeon Dr. Max Findlay.

The University of Alberta Hospital is the only facility in Alberta that uses the $380,000 Zeiss OPMI Pentero, which was completely funded by the University Hospital Foundation. It’s the world’s first surgical microscope built specifically to support a procedure called fluorescence angiography. A special green dye is injected intravenously and made visible by infrared light as it flows through the arteries, capillaries and veins of the brain.

About a dozen patients have benefited from the technology since it was introduced at University of Alberta Hospital in late December. Many of these patients have vascular brain conditions such as aneurysm (blister-like bulge that weakens a blood-vessel wall), arteriovenous malformation (abnormal connection between veins and arteries, usually congenital) and fistula (an abnormal connection or passageway between two vessels).

“The beauty of fluorescence angiography is its simplicity. The anesthetist just injects the dye into a peripheral vein and, in seconds, you’re looking through the microscope at the surgical target,” says Dr. Findlay.

“Before, we relied on a complicated catheter angiogram. We’d put a catheter in an artery, feed it to the arteries of the brain and inject a dye — not a fluorescent dye — that makes the blood vessels stand out as black on an X-ray. This standard angiogram is still a safe, effective procedure but it typically requires us to keep the patient in hospital for an additional day or two to verify its success. Fluorescence angiography is just better technology.”

David Corneau, a 33-year-old father of three, recently underwent two hours of aneurysm surgery in which Dr. Findlay used fluorescence angiography to verify the success of the procedure. He was back at home, feeling better, within 24 hours.

“I came in really, really scared last night, thinking that it’s my last day, and I’m going home today to play with my kids,” says Corneau. “I completely got my strength back already. The care has been amazing and the technology is pretty cool.”

Community generosity helped to make it all possible.

“We would not be able to have this advanced technology at our hospital right now without the support of the many donors to our annual campaign and the $1 million raised through the Festival of Trees in support of neurosciences,” says Joyce Mallman Law, president of University Hospital Foundation.

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than 3.7 million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

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