Monitoring shunt flow by jugular bulb oxygen saturation during therapeutic embolisation of cerebral arteriovenous malformations
The shunt flow to perfusion flow ratio in patients with cerebral arteriovenous malformation (AVM) can be evaluated from the arterial and jugular bulb oxygen saturations (S aO2 and S jO2). We employed this technique to assess the progress of shunt obliteration during therapeutic embolisation procedures. Data from a consecutive series of 15 large supratentorial high-flow AVMs (maximum diameter > 4 cm) were analysed. The S jO2 before embolisation was significantly higher than the S jO2 at the end of the embolisation. Continuous monitoring of S jO2 revealed a progressive decrease in association with an increase in the circulation time, as well as disappearance of early veins and evidence of steal during the embolisation procedure. This technique is useful for real-time assessment of the progress of embolisation.
Key wordsArteriovenous malformation Embolisation Oxygen saturation Jugular bulb