Usefulness of near-infrared spectroscopy in thrombectomy monitoring

Monitoring recanalization and reperfusion during acute ischemic stroke is a challenge for therapeutic assessment. Near-infrared spectroscopy (NIRS) allows continuous monitoring of the brain regional saturation of oxygen (rSO2). We sought to evaluated rSO2 variation during mechanical thrombectomy during acute ischemic stroke. Three patients admitted for middle cerebral artery occlusion were continuously monitored during mechanical thrombectomy (rSO2 in the infarcted and non-infarcted side and interhemispheric difference). The procedure was a success in two of them and failed in the third. At the beginning, rSO2 was lower in the infarcted side and interhemispheric difference was more than 5 %. When the procedure succeeded, rSO2 in the infarcted side rise (about 10 %) and interhemisperic difference decrease (about 7 %). When the procedure failed, rSO2 was the same at the beginning and at the end. NIRS may be useful to monitor recanalization during management of acute ischemic stroke.

[1]  M. Czerny,et al.  Comparing Doppler Ultrasonography and Cerebral Oximetry as Indicators for Shunting in Carotid Endarterectomy , 2000, Anesthesia and analgesia.

[2]  Paolo Maria Rossini,et al.  Transcranial Doppler and Near-Infrared Spectroscopy Can Evaluate the Hemodynamic Effect of Carotid Artery Occlusion , 2003, Stroke.

[3]  Stefan Moritz,et al.  Accuracy of Cerebral Monitoring in Detecting Cerebral Ischemia during Carotid Endarterectomy: A Comparison of Transcranial Doppler Sonography, Near-infrared Spectroscopy, Stump Pressure, and Somatosensory Evoked Potentials , 2007, Anesthesiology.

[4]  T. W. L. Scheeren,et al.  Monitoring tissue oxygenation by near infrared spectroscopy (NIRS): background and current applications , 2012, Journal of Clinical Monitoring and Computing.

[5]  C. Elwell,et al.  Cerebral Near-Infrared Spectroscopy in Adults: A Work in Progress , 2012, Anesthesia and analgesia.

[6]  MakioKaminogo,et al.  An Additional Monitoring of Regional Cerebral Oxygen Saturation to HMPAO SPECT Study During Balloon Test Occlusion , 1999 .

[7]  M. Damian,et al.  Bilateral near infrared spectroscopy in space-occupying middle cerebral artery stroke , 2007, Neurocritical care.

[8]  G. Schroth,et al.  Monitoring cerebral oxygenation during balloon occlusion with multichannel NIRS , 2013, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[9]  P. Al-Rawi,et al.  Tissue Oxygen Index: Thresholds for Cerebral Ischemia Using Near-Infrared Spectroscopy , 2006, Stroke.