Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS

作者：Rummel Christian^*; Zubler Christoph; Schroth Gerhard; Gralla Jan; Hsieh Kety; Abela Eugenio; Hauf Martinus; Meier Niklaus; Verma Rajeev K; Andres Robert H; Nirkko Arto C; Wiest Roland

来源：Journal of Cerebral Blood Flow and Metabolism, 2014, 34(2): 347-356.

DOI：10.1038/jcbfm.2013.207

• angiography
• cerebral blood flow measurement
• interventional neuroradiology
• near infrared spectroscopy
• neuroradiology

We report on oxygenation changes noninvasively recorded by multichannel continuous-wave near infrared spectroscopy (CW-NIRS) during endovascular neuroradiologic interventions requiring temporary balloon occlusion of arteries supplying the cerebral circulation. Digital subtraction angiography (DSA) provides reference data on the site, timing, and effectiveness of the flow stagnation as well as on the amount and direction of collateral circulation. This setting allows us to relate CW-NIRS findings to brain specific perfusion changes. We focused our analysis on the transition from normal perfusion to vessel occlusion, i.e., before hypoxia becomes clinically apparent. The localization of the maximal response correlated either with the core (occlusion of the middle cerebral artery) or with the watershed areas (occlusion of the internal carotid artery) of the respective vascular territories. In one patient with clinically and angiographically confirmed insufficient collateral flow during carotid artery occlusion, the total hemoglobin concentration became significantly asymmetric, with decreased values in the ipsilateral watershed area and contralaterally increased values. Multichannel CW-NIRS monitoring might serve as an objective and early predictive marker of critical perfusion changes during interventions to prevent hypoxic damage of the brain. It also might provide valuable human reference data on oxygenation changes as they typically occur during acute stroke.

• 出版日期2014-2