Intraoperative cerebral hemodynamic monitoring during carotid endarterectomy via diffuse correlation spectroscopy and near-infrared spectroscopy

Kutlu Kaya*, Alexander I. Zavriyev, Felipe Orihuela-Espina, Mirela V. Simon, Glenn M. LaMuraglia, Eric T. Pierce, Maria Angela Franceschini, John Sunwoo*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Objective: This pilot study aims to show the feasibility of noninvasive and real-time cerebral hemodynamic monitoring during carotid endarterectomy (CEA) via diffuse correlation spectroscopy (DCS) and near-infrared spectroscopy (NIRS).

Methods: Cerebral blood flow index (CBFi) was measured unilaterally in seven patients and bilaterally in seventeen patients via DCS. In fourteen patients, hemoglobin oxygenation changes were measured bilaterally and simultaneously via NIRS. Cerebral autoregulation (CAR) and cerebrovascular resistance (CVR) were estimated using CBFi and arterial blood pressure data. Further, compensatory responses to the ipsilateral hemisphere were investigated at different contralateral stenosis levels.

Results: Clamping of carotid arteries caused a sharp increase of CVR (~70%) and a marked decrease of ipsilateral CBFi (57%). From the initial drop, we observed partial recovery in CBFi, an increase of blood volume, and a reduction in CVR in the ipsilateral hemisphere. There were no significant changes in compensatory responses between different contralateral stenosis levels as CAR was intact in both hemispheres throughout the CEA phase. A comparison between hemispheric CBFi showed lower ipsilateral levels during the CEA and post-CEA phases (p < 0.001, 0.03).

Conclusion: DCS alone or combined with NIRS is a useful monitoring technique for real-time assessment of cerebral hemodynamic changes and allows individualized strategies to improve cerebral perfusion during CEA by identifying different hemodynamic metrics.

Original languageEnglish
Article number1025
Number of pages17
JournalBrain Sciences
Volume12
Issue number8
DOIs
Publication statusPublished - 2 Aug 2022

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health grants R01GM116177 and R01HD0091067.

Publisher Copyright:
© 2022 by the authors.

Keywords

  • carotid endarterectomy
  • cerebral autoregulation
  • cerebral blood flow
  • diffuse correlation spectroscopy
  • intraoperative neuromonitoring
  • near-infrared spectroscopy

ASJC Scopus subject areas

  • General Neuroscience

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