Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS

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 (2014). Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS. Journal of cerebral blood flow and metabolism, 34(2), pp. 347-356. Nature Publishing Group 10.1038/jcbfm.2013.207

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Rummel, Christian; Zubler, Christoph; Schroth, Gerhard; Gralla, Jan; Hsieh, Kety Wha-Vei; Abela, Eugenio; Hauf, Martinus; Meier, Niklaus; Verma, Rajeev Kumar; Andres, Robert; Nirkko, Arto Christian and Wiest, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0271-678X

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Nicole Söll

Date Deposited:

18 Aug 2014 09:58

Last Modified:

26 Jun 2016 01:49

Publisher DOI:

10.1038/jcbfm.2013.207

PubMed ID:

24301292

Uncontrolled Keywords:

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

BORIS DOI:

10.7892/boris.45807

URI:

https://boris.unibe.ch/id/eprint/45807

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