Near-infrared spectroscopy in carotid artery stenting predicts cerebral hyperperfusion syndrome

S. Matsumoto, I. Nakahara, T. Higashi, Y. Iwamuro, Y. Watanabe, K. Takahashi, M. Ando, M. Takezawa, J. I. Kira

研究成果: Contribution to journalArticle査読

45 被引用数 (Scopus)

抄録

Objective: Cerebral hyperperfusion syndrome (CHS) following carotid artery stenting (CAS) or carotid endarterectomy (CEA) is rare but often fatal once intracranial hemorrhage has occurred. In particular, CHS occurs significantly earlier after CAS than after CEA. Thus a monitoring method for early detection of CHS is required. Near-infrared spectroscopy (NIRS) provides a noninvasive monitoring technique for assessing regional cerebral oxygen saturation (rSO2). This study evaluated the usefulness of transcranial NIRS during CAS for prediction of CHS. Methods: Periprocedural rSO2 was monitored in 64 cases of CAS (52 men, 12 women; 71 ± 6.6 years). The average degree of carotid stenosis was 76.8 ± 11.3% by North American Symptomatic Carotid Endarterectomy Trial criteria. Bifrontal rSO2 was monitored during the procedure using NIRS. Seventeen patients were symptomatic and 47 were asymptomatic. CHS was diagnosed by increased cerebral blood flow by SPECT performed on the day after treatment with deterioration of neurologic symptoms. Results: CHS was observed in two cases (3.1%). In the CHS group, post-reperfusion rSO2 values increased >24% from baseline until 3 minutes after reperfusion. In the non-CHS group, the normal upper limit (NUL) of the rSO2 change was set at 10.0% at 3 minutes after reperfusion. In the CHS group, rSO2 at 3 minutes after reperfusion was markedly higher than the NUL. In patients showing an rSO2 at 3 minutes after reperfusion increased by more than 10.0%, CHS following CAS could be predicted. CONCLUSION: Periprocedural increases in regional cerebral oxygen saturation measured by near- infrared spectroscopy can be an excellent predictor of cerebral hyperperfusion syndrome after carotid artery stenting.

本文言語英語
ページ(範囲)1512-1518
ページ数7
ジャーナルNeurology
72
17
DOI
出版ステータス出版済み - 4 28 2009

All Science Journal Classification (ASJC) codes

  • 臨床神経学

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