title: Brain tissue oxygen monitoring to assess reperfusion after intra-arterial treatment of aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm: a retrospective study.
abstract: OBJECTIVE
  Cerebral vasospasm resistant to medical management frequently requires intra-arterial spasmolysis. Angiographic resolution of vasospasm does not provide physiologic data on the adequacy of reperfusion. We recorded pre- and postspasmolysis PbO(2) data in the endovascular suite to determine whether this physiologic parameter could be used to determine when successful reperfusion was established.
  
  
  METHODS
  Eight patients with 10 Licox monitors and cerebral vasospasm underwent intra-arterial spasmolysis. Pre- and postspasmolytic PbO(2) was recorded for comparison. Other physiologic parameters, such as CPP, ICP, SaO(2), and Fio(2), were also recorded.
  
  
  RESULTS
  Mean prespasmolysis PbO(2) recordings were 35.2 and 27.3 for the mild-to-moderate and moderate-to-severe vasospasm group, respectively. Mean postspasmolysis PbO(2) increased to 40.3 and 38.4, respectively, which was statistically significant (P < .05) for both groups. In 100% of instances in the moderate-to-severe group and 83% of instances in mild-to-moderate group, the mean PbO(2) increased after spasmolysis and correlated with improvement in angiographic vasospasm. Other physiologic parameters, such as CPP, ICP, SaO(2), and Fio(2), did not show any statistically significant difference before and after spasmolysis.
  
  
  CONCLUSIONS
  PbO(2) monitoring provides the interventionalist with an objective physiologic parameter to determine adequate spasmolysis. Further investigation is needed to establish target PbO(2) rates indicative of adequate reperfusion, which can be used in the endovascular suite.
authors.affiliation: Department of Neurosurgery, SUNY Upstate Neurovascular Center, SUNY Upstate Medical University, 750 East Adams St, Syracuse, NY 13210, USA. deshaiee@upstate.edu
authors.forename: E M
authors.initials: EM
authors.lastname: Deshaies
authors.forename: W
authors.initials: W
authors.lastname: Jacobsen
authors.forename: A
authors.initials: A
authors.lastname: Singla
authors.forename: F
authors.initials: F
authors.lastname: Li
authors.forename: R
authors.initials: R
authors.lastname: Gorji
mesh_terms: D000328:Adult; D001921:Brain / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000032:analysis*; D010477:Perfusion / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery*; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery*; D055815:Young Adult
chemical_list: D010100:Oxygen