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

doi:10.3390/brainsci12081025

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

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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 (CBF_i) 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 CBF_i 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 CBF_i (57%). From the initial drop, we observed partial recovery in CBF_i, 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 CBF_i 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 language	English
Article number	1025
Number of pages	17
Journal	Brain Sciences
Volume	12
Issue number	8
DOIs	https://doi.org/10.3390/brainsci12081025
Publication status	Published - 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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KayaK2022IntraoperativeFinal published version, 4.49 MBLicence: Creative Commons: Attribution (CC BY)

Cite this

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title = "Intraoperative cerebral hemodynamic monitoring during carotid endarterectomy via diffuse correlation spectroscopy and near-infrared spectroscopy",

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.",

keywords = "carotid endarterectomy, cerebral autoregulation, cerebral blood flow, diffuse correlation spectroscopy, intraoperative neuromonitoring, near-infrared spectroscopy",

author = "Kutlu Kaya and Zavriyev, {Alexander I.} and Felipe Orihuela-Espina and Simon, {Mirela V.} and LaMuraglia, {Glenn M.} and Pierce, {Eric T.} and Franceschini, {Maria Angela} and John Sunwoo",

note = "Funding Information: This work was supported by the National Institutes of Health grants R01GM116177 and R01HD0091067. Publisher Copyright: {\textcopyright} 2022 by the authors.",

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doi = "10.3390/brainsci12081025",

language = "English",

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T1 - Intraoperative cerebral hemodynamic monitoring during carotid endarterectomy via diffuse correlation spectroscopy and near-infrared spectroscopy

AU - Kaya, Kutlu

AU - Zavriyev, Alexander I.

AU - Orihuela-Espina, Felipe

AU - Simon, Mirela V.

AU - LaMuraglia, Glenn M.

AU - Pierce, Eric T.

AU - Franceschini, Maria Angela

AU - Sunwoo, John

PY - 2022/8/2

Y1 - 2022/8/2

N2 - 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.

AB - 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.

KW - carotid endarterectomy

KW - cerebral autoregulation

KW - cerebral blood flow

KW - diffuse correlation spectroscopy

KW - intraoperative neuromonitoring

KW - near-infrared spectroscopy

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

Abstract

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Keywords

ASJC Scopus subject areas

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