title: Monitoring of filter patency during carotid artery stenting using near-infrared spectroscopy with high time-resolution.
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.
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan. igarashi.takahiro@nihon-u.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Igarashi
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.|Department of Electrical and Electronics Engineering, Nihon University College of Engineering, NEWCAT Institute, Fukushima, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sakatani
authors.affiliation: Department of Neuroendovascular Therapy, Sagamihara Kyodo Hospital, Kanagawa, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shibuya
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Teruyasu
authors.initials: T
authors.lastname: Hirayama
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yoshino
authors.affiliation: Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000601:surgery*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010108:Oxyhemoglobins / Q000032:analysis; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D015607:Stents
chemical_list: D006454:Hemoglobins; D010108:Oxyhemoglobins; C100003:deoxyhemoglobin