• Tatsuya Hoshino, Yoichi Katayama, Kaoru Sakatani, Tsuneo Kano, and Yoshihiro Murata.
• Department of Neurological Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan.
• Surg Neurol. 2006 Jun 1;65(6):569-76; discussion 576.

BackgroundCerebrovascular reconstruction procedures run the risk of changing the balance between oxygen supply and consumption during surgery. We assessed the value of visual light spectroscopy for detecting changes in cerebral blood oxygenation (CBO) during superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis.MethodsWe developed a VLS monitoring system which permits continuous monitoring of CBO changes during surgery. Using the VLS, we evaluated the CBO changes in the MCA territory on the lesion side in 18 patients who underwent STA-MCA anastomosis.ResultsTemporary occlusion of the MCA (M4 portion) did not change the CBO in 17 patients. However, in the patient with dissecting aneurysm, it caused decreases of oxyhemoglobin and cortical oxygen saturation (CoSo(2)) associated with an increase of deoxyhemoglobin, although these CBO changes were normalized by STA blood flow. In 5 patients, STA blood flow increased the oxyhemoglobin and CoSo(2) and decreased the deoxyhemoglobin, indicating that cortical blood flow (CoBF) was increased. The CoSo(2) before anastomosis was significantly low in the patients who showed an increase of CoSo(2) by STA blood flow (63.0% +/- 2.5%) as compared with those who did not (72.0 +/- 6.1%, P = .024).ConclusionTemporary occlusion of a cortical artery during bypass surgery did not affect the CBO in patients who had chronic cerebral ischemia, but caused acute ischemia in the patient who did not. STA blood flow increased the CoBF during surgery more frequently in patients who showed a low perfusion pressure. The VLS monitoring system is considered useful for evaluating bypass function and facilitates safe and accurate bypass surgery.

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