-
Neurological research · Sep 2009
Early post-ischemic hyperemia on transcranial cerebral oxygen saturation monitoring in carotid endarterectomy is associated with severity of cerebral ischemic insult during carotid artery clamping.
- Masakazu Kobayashi, Kuniaki Ogasawara, Yasunori Suga, Kohei Chida, Kenji Yoshida, Yasunari Otawara, Eiki Tsushima, and Akira Ogawa.
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
- Neurol. Res. 2009 Sep 1; 31 (7): 728-33.
Background And ObjectiveIn animal models, the magnitude of early post-ischemic hyperemia tends to correlate with the duration and intensity of prior ischemic insult. The aim of this study was to determine whether early post-ischemic hyperemia in human brain during carotid endarterectomy (CEA) is associated with the severity of cerebral ischemic insult during clamping of the internal carotid artery (ICA).MethodsTranscranial cerebral oxygen saturation using near-infrared spectroscopy was monitored intraoperatively in 171 patients undergoing CEA for ipsilateral ICA stenosis (>70%) to assess the intensity of cerebral hemispheric ischemia during ICA clamping and the magnitude of early post-ischemic hyperemia after ICA declamping.ResultsEarly post-ischemic hyperemia peaked within 3 minutes after ICA declamping and resolved at 20 minutes after ICA declamping. A significant correlation was observed between the magnitude of early post-ischemic hyperemia and the intensity of cerebral ischemia (r=0.697; p<0.0001). Eight patients recovered from anesthesia with a new minor neurological deficit on the side contralateral to the CEA (4.7%). Analysis by receiver operating characteristics (ROC) curve was used to estimate the ability to discriminate between patients with and without post-operative development of new neurological deficits. Area under the ROC curve was significantly greater when analysing the magnitude of early post-ischemic hyperemia (1.00; 95% CI: 0.99-1.00) when compared with the intensity of cerebral ischemia (0.93; 95% CI: 0.89-0.98) (p<0.01).ConclusionEarly post-ischemic hyperemia in CEA is correlated with the severity of cerebral ischemic insult during clamping of the ICA.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.