Transcranial Optical Monitoring of Cerebral Hemodynamics in Acute Stroke Patients during Mechanical Thrombectomy
| Autor: | Michael T. Mullen, Steven R. Messé, Wesley B. Baker, Rodrigo M. Forti, Scott E. Kasner, Rickson C. Mesquita, Christopher G. Favilla, Bryan Pukenas, Neda I. Sedora-Roman, Robert W. Hurst, Omar Choudhri, Jeffrey M. Cochran, John A. Detre, Arjun G. Yodh, David Kung, W. Andrew Kofke, Ramani Balu |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Time Factors Perfusion Imaging medicine.medical_treatment Hemodynamics Article Brain Ischemia 03 medical and health sciences Cerebral circulation 0302 clinical medicine Predictive Value of Tests medicine.artery Internal medicine Humans Medicine Aged Thrombectomy Aged 80 and over business.industry Cerebral infarction Microcirculation Spectrum Analysis Optical Imaging Rehabilitation Thrombolysis Blood flow Middle Aged medicine.disease Frontal Lobe Stroke Treatment Outcome Cerebral blood flow Frontal lobe Cerebrovascular Circulation Cardiology Female Surgery Neurology (clinical) Internal carotid artery Cardiology and Cardiovascular Medicine business Blood Flow Velocity 030217 neurology & neurosurgery |
| Zdroj: | J Stroke Cerebrovasc Dis |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2019.03.019 |
| Popis: | INTRODUCTION: Mechanical thrombectomy is revolutionizing treatment of acute stroke due to large vessel occlusion (LVO). Unfortunately, use of the modified Thrombolysis in Cerebral Infarction score (mTICI) to characterize recanalization of the cerebral vasculature does not address microvascular perfusion of the distal parenchyma, nor provide more than a vascular “snapshot”. Thus, little is known about tissue-level hemodynamic consequences of LVO recanalization. Diffuse correlation spectroscopy (DCS) and diffuse optical spectroscopy (DOS) are promising methods for continuous, non-invasive, contrast-free transcranial monitoring of cerebral microvasculature. METHODS: Here we use a combined DCS/DOS system to monitor frontal lobe hemodynamic changes during endovascular treatment of two patients with ischemic stroke due to cervical internal carotid artery (ICA) occlusions. RESULTS AND DISCUSSION: The monitoring instrument identified a recanalization-induced increase in ipsilateral cerebral blood flow (CBF) with little or no concurrent change in contralateral CBF and extracerebral blood flow. The results suggest that diffuse optical monitoring is sensitive to intracerebral hemodynamics in patients with cervical ICA occlusion and can measure microvascular responses to mechanical thrombectomy. |
| Databáze: | OpenAIRE |
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