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Intra-operative Video Characterization of Carotid Artery Pulsation Patterns in Case Series with Post-endarterectomy Hypertension and Hyperperfusion Syndrome

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Abstract

Cerebral hyperperfusion syndrome (CHS) is a complication that can occur after carotid endarterectomy (CEA), the treatment of choice to decrease the subsequent risk of fatal or disabling stroke for patients with symptomatic severe stenosis of the carotid artery. Because of its rarity and complexity, the mechanism of the condition is still unclear, making its prevention via prediction and monitoring challenging. This is especially true during surgery, when multiple factors can induce physiological changes, including blood pressure and baroreceptor functions, which are crucial factors for post-CEA hypertension and CHS. Thus, with intra-operative videos taken by surgical microscopes, we employed a new video processing technique to magnify ordinarily invisible carotid artery pulsation patterns as rhythmic color fluctuations. We applied the technique for three CEA cases, two of which developed CHS with post-CEA hypertension. For those with CHS, abnormal pulsation patterns were detected at the site of the baroreceptors. The results suggested that intra-operative baroreceptor dysfunction can potentially be linked with post-operative hypertension, as well as the occurrence of CHS. Guided by the preliminary discovery, further investigation may help establish the introduced technique as a simple and contactless technique to help predict post-CEA hypertension and CHS in order to facilitate the management and understanding of the condition and improve the care of CEA.

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Authors and Affiliations

  1. PERFORM Centre, Concordia University, Rm 2.211, 7200 Sherbrooke St. W., Montreal, H4B 1R6, Canada

    Yiming Xiao & Hassan Rivaz

  2. Department of Electrical and Computer Engineering, Concordia University, Montreal, Canada

    Yiming Xiao & Hassan Rivaz

  3. Department of Neurosurgery, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan

    Hidetoshi Kasuya & Suguru Yokosako

  4. Montreal Neurological Hospital, Montreal, Canada

    Cristina Mindru, Jeanne Teitelbaum, Denis Sirhan, David Sinclair, Mark Angle & Benjamin W. Y. Lo

Authors
  1. Yiming Xiao
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  2. Hassan Rivaz
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  3. Hidetoshi Kasuya
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  4. Suguru Yokosako
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  5. Cristina Mindru
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  6. Jeanne Teitelbaum
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  7. Denis Sirhan
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  8. David Sinclair
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  9. Mark Angle
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  10. Benjamin W. Y. Lo
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Correspondence to Yiming Xiao.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all participants included in the study.

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Xiao, Y., Rivaz, H., Kasuya, H. et al. Intra-operative Video Characterization of Carotid Artery Pulsation Patterns in Case Series with Post-endarterectomy Hypertension and Hyperperfusion Syndrome. Transl. Stroke Res. 9, 452–458 (2018). https://doi.org/10.1007/s12975-017-0605-8

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  • DOI: https://doi.org/10.1007/s12975-017-0605-8

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