title: Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS.
abstract: We report on oxygenation changes noninvasively recorded by multichannel continuous-wave near infrared spectroscopy (CW-NIRS) during endovascular neuroradiologic interventions requiring temporary balloon occlusion of arteries supplying the cerebral circulation. Digital subtraction angiography (DSA) provides reference data on the site, timing, and effectiveness of the flow stagnation as well as on the amount and direction of collateral circulation. This setting allows us to relate CW-NIRS findings to brain specific perfusion changes. We focused our analysis on the transition from normal perfusion to vessel occlusion, i.e., before hypoxia becomes clinically apparent. The localization of the maximal response correlated either with the core (occlusion of the middle cerebral artery) or with the watershed areas (occlusion of the internal carotid artery) of the respective vascular territories. In one patient with clinically and angiographically confirmed insufficient collateral flow during carotid artery occlusion, the total hemoglobin concentration became significantly asymmetric, with decreased values in the ipsilateral watershed area and contralaterally increased values. Multichannel CW-NIRS monitoring might serve as an objective and early predictive marker of critical perfusion changes during interventions-to prevent hypoxic damage of the brain. It also might provide valuable human reference data on oxygenation changes as they typically occur during acute stroke.
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Rummel
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Zubler
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schroth
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Gralla
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Kety
authors.initials: K
authors.lastname: Hsieh
authors.affiliation: 1] Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland [2] Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Abela
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Martinus
authors.initials: M
authors.lastname: Hauf
authors.affiliation: Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Meier
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Rajeev K
authors.initials: RK
authors.lastname: Verma
authors.affiliation: Department of Neurosurgery, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Andres
authors.affiliation: Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Arto C
authors.initials: AC
authors.lastname: Nirkko
authors.affiliation: Support Center for Advanced Neuroimaging (SCAN), University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Wiest
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry / Q000295:instrumentation / Q000379:methods*; D013055:Spectrophotometry, Infrared / Q000295:instrumentation / Q000379:methods