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Monitoring of Filter Patency During Carotid Artery Stenting Using Near-Infrared Spectroscopy with High Time-Resolution

  • Takahiro Igarashi
  • Kaoru Sakatani
  • Tadashi Shibuya
  • Teruyasu Hirayama
  • Atsuo Yoshino
  • Yoichi Katayama
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 812)

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.

Keywords

Advanced imaging techniques Carotid artery stenting (CAS) Embolism Intraoperative monitoring Near-infrared spectroscopy (NIRS) 

Notes

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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Copyright information

© Springer Science+Business Media, LLC 2014

Authors and Affiliations

  • Takahiro Igarashi
    • 1
  • Kaoru Sakatani
    • 1
    • 2
  • Tadashi Shibuya
    • 3
  • Teruyasu Hirayama
    • 1
  • Atsuo Yoshino
    • 1
  • Yoichi Katayama
    • 1
  1. 1.Division of Neurosurgery, Department of Neurological SurgeryNihon University School of MedicineItabashi-kuJapan
  2. 2.Department of Electrical and Electronics EngineeringNihon University College of Engineering, NEWCAT InstituteFukushimaJapan
  3. 3.Department of Neuroendovascular TherapySagamihara Kyodo HospitalKanagawaJapan

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