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The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study

There has been no gold standard for intraoperative monitoring in carotid endarterectomy (CEA) till now. The purpose of the current study was to investigate the value of near-infrared spectroscopy (NIRS) monitoring in CEA and explore the thresholds for intraoperative cerebral hypoperfusion. Eighty-fo...

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Autores principales: Wang, Yu, Li, Li, Wang, Tianlong, Zhao, Lei, Feng, Hua, Wang, Qian, Fan, Long, Feng, Xuexin, Xiao, Wei, Feng, Kunpeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362521/
https://www.ncbi.nlm.nih.gov/pubmed/30545240
http://dx.doi.org/10.1177/0963689718817760
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author Wang, Yu
Li, Li
Wang, Tianlong
Zhao, Lei
Feng, Hua
Wang, Qian
Fan, Long
Feng, Xuexin
Xiao, Wei
Feng, Kunpeng
author_facet Wang, Yu
Li, Li
Wang, Tianlong
Zhao, Lei
Feng, Hua
Wang, Qian
Fan, Long
Feng, Xuexin
Xiao, Wei
Feng, Kunpeng
author_sort Wang, Yu
collection PubMed
description There has been no gold standard for intraoperative monitoring in carotid endarterectomy (CEA) till now. The purpose of the current study was to investigate the value of near-infrared spectroscopy (NIRS) monitoring in CEA and explore the thresholds for intraoperative cerebral hypoperfusion. Eighty-four consecutive patients who underwent CEA surgery in Xuan Wu Hospital of Capital Medical University from August 2015 to June 2016 were enrolled in this study. All patients were intraoperatively monitored by transcranial Doppler ultrasonography (TCD) and NIRS. Regional oxygen saturation (rSO(2)) monitored by NIRS and blood flow velocity of the middle cerebral artery (V-MCA) monitored by TCD were continuously recorded. Correlation analysis was conducted for NIRS and TCD monitoring values. Intraoperative shunting was performed in five patients according to the TCD monitoring results and surgeon preference. During clamping of the carotid artery, the Pearson correlation index between rSO(2) and V-MCA was 0.581 (P<0.001). A cut-off of 12.3% decrease of rSO(2) was identified as the optimal threshold for intraoperative hypoperfusion indicated by TCD monitoring, when the sensitivity and specificity were 74.6% and 91.7%, respectively, with a 0.609 Kappa value. Physical examination immediately after operation showed no ischemic injury occurred, and no death and stroke occurred during the postoperative hospitalization. Our study demonstrated that NIRS could serve as a favorable monitoring tool during CEA. A 12.3% decrease of rSO(2) could be adopted as a reliable threshold for intraoperative cerebral hypoperfusion.
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spelling pubmed-63625212019-02-15 The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study Wang, Yu Li, Li Wang, Tianlong Zhao, Lei Feng, Hua Wang, Qian Fan, Long Feng, Xuexin Xiao, Wei Feng, Kunpeng Cell Transplant Original Articles There has been no gold standard for intraoperative monitoring in carotid endarterectomy (CEA) till now. The purpose of the current study was to investigate the value of near-infrared spectroscopy (NIRS) monitoring in CEA and explore the thresholds for intraoperative cerebral hypoperfusion. Eighty-four consecutive patients who underwent CEA surgery in Xuan Wu Hospital of Capital Medical University from August 2015 to June 2016 were enrolled in this study. All patients were intraoperatively monitored by transcranial Doppler ultrasonography (TCD) and NIRS. Regional oxygen saturation (rSO(2)) monitored by NIRS and blood flow velocity of the middle cerebral artery (V-MCA) monitored by TCD were continuously recorded. Correlation analysis was conducted for NIRS and TCD monitoring values. Intraoperative shunting was performed in five patients according to the TCD monitoring results and surgeon preference. During clamping of the carotid artery, the Pearson correlation index between rSO(2) and V-MCA was 0.581 (P<0.001). A cut-off of 12.3% decrease of rSO(2) was identified as the optimal threshold for intraoperative hypoperfusion indicated by TCD monitoring, when the sensitivity and specificity were 74.6% and 91.7%, respectively, with a 0.609 Kappa value. Physical examination immediately after operation showed no ischemic injury occurred, and no death and stroke occurred during the postoperative hospitalization. Our study demonstrated that NIRS could serve as a favorable monitoring tool during CEA. A 12.3% decrease of rSO(2) could be adopted as a reliable threshold for intraoperative cerebral hypoperfusion. SAGE Publications 2018-12-14 2019-02 /pmc/articles/PMC6362521/ /pubmed/30545240 http://dx.doi.org/10.1177/0963689718817760 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Wang, Yu
Li, Li
Wang, Tianlong
Zhao, Lei
Feng, Hua
Wang, Qian
Fan, Long
Feng, Xuexin
Xiao, Wei
Feng, Kunpeng
The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study
title The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study
title_full The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study
title_fullStr The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study
title_full_unstemmed The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study
title_short The Efficacy of Near-Infrared Spectroscopy Monitoring in Carotid Endarterectomy: A Prospective, Single-Center, Observational Study
title_sort efficacy of near-infrared spectroscopy monitoring in carotid endarterectomy: a prospective, single-center, observational study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362521/
https://www.ncbi.nlm.nih.gov/pubmed/30545240
http://dx.doi.org/10.1177/0963689718817760
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