Abstract
We aimed to evaluate the usefulness of a newly developed, near-infrared spectroscopy (NIRS) device for monitoring hemodynamic changes during carotid artery stenting (CAS), as a means to detect filter obstruction due to distal embolism. We evaluated 16 patients with internal carotid artery (ICA) stenosis during the CAS procedure, using a NIRS system that can monitor not only changes in oxygenation of hemoglobin (Hb), but also the fluctuation of oxyhemoglobin (oxy-Hb) synchronized with heartbeat. The NIRS system detected a marked decrease of oxy-Hb and an increase of deoxyhemoglobin (deoxy-Hb) during ICA occlusion in patients without anterior cross circulation (ACC). Patients with ACC showed much smaller changes. The analysis of oxy-Hb fluctuation made it possible to detect occurrence of no-flow in the absence of Hb concentration changes. The amplitude of oxy-Hb fluctuation in the no/slow-flow group was significantly smaller than that in the normal-flow group. Our results indicate that the present high time-resolution NIRS device, which can measure oxy-Hb fluctuation, is superior to conventional NIRS for detecting filter obstruction.
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Acknowledgments
This research was partly supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Sciences and Technology of Japan (B23300247), and grants by Alpha Electron Co., Ltd. (Fukushima, Japan) and Iing CO., LTD (Tokyo, Japan).
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Igarashi, T., Sakatani, K., Shibuya, T., Hirayama, T., Yoshino, A., Katayama, Y. (2014). Monitoring of Filter Patency During Carotid Artery Stenting Using Near-Infrared Spectroscopy with High Time-Resolution. In: Swartz, H.M., Harrison, D.K., Bruley, D.F. (eds) Oxygen Transport to Tissue XXXVI. Advances in Experimental Medicine and Biology, vol 812. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0620-8_43
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DOI: https://doi.org/10.1007/978-1-4939-0620-8_43
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