Is Near-Infrared Spectroscopy a Reliable Method to Evaluate Clamping Ischemia during Carotid Surgery?
Joint Authors
Pedrini, Luciano
Magnoni, Filippo
Ballestrazzi, Maria Sandra
Sensi, Luigi
Cirelli, Maria Rosaria
Pisano, Emilio
Pilato, Alessandro
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2011-11-09
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Guidelines do not include cerebral oximetry among monitoring for carotid endarterectomy (CEA).
The purpose of this study was to evaluate the reliability of near-infrared spectroscopy (NIRS) in the detection of clamping ischemia and in the prevention of clamping-related neurologic deficits using, as a cutoff for shunting, a 20% regional cerebral oxygen saturation (rSO2) decrease if persistent more than 4 minutes, otherwise a 25% rSO2 decrease.
Bilateral rSO2 was monitored continuously in patients undergoing CEA under general anesthesia (GA).
Data was recorded after clamping, declamping, during shunting and lowest values achieved.
Preoperative neurologic, CT-scan, and vascular lesions were recorded.
We reviewed 473 cases: 305 males (64.5%) mean age 73.3±7.3.
Three patients presented transient ischemic deficits at awakening, no perioperative stroke or death; 41 (8.7%) required shunting: 30 based on the initial rSO2 value and 11 due to a decrease during surgery.
Using the ROC curve analysis we found, for a >25% reduction from baseline value, a sensitivity of 100% and a specificity of 90.6%.
Reliability, PPV, and NPV were 95.38%, 9%, and 100%, respectively.
In conclusion, this study indicates the potential reliability of NIRS monitoring during CEA under GA, using a cutoff of 25% or a cutoff of 20% for prolonged hypoperfusion.
American Psychological Association (APA)
Pedrini, Luciano& Magnoni, Filippo& Sensi, Luigi& Pisano, Emilio& Ballestrazzi, Maria Sandra& Cirelli, Maria Rosaria…[et al.]. 2011. Is Near-Infrared Spectroscopy a Reliable Method to Evaluate Clamping Ischemia during Carotid Surgery?. Stroke Research and Treatment،Vol. 2012, no. 2012, pp.1-7.
https://search.emarefa.net/detail/BIM-450330
Modern Language Association (MLA)
Pedrini, Luciano…[et al.]. Is Near-Infrared Spectroscopy a Reliable Method to Evaluate Clamping Ischemia during Carotid Surgery?. Stroke Research and Treatment No. 2012 (2012), pp.1-7.
https://search.emarefa.net/detail/BIM-450330
American Medical Association (AMA)
Pedrini, Luciano& Magnoni, Filippo& Sensi, Luigi& Pisano, Emilio& Ballestrazzi, Maria Sandra& Cirelli, Maria Rosaria…[et al.]. Is Near-Infrared Spectroscopy a Reliable Method to Evaluate Clamping Ischemia during Carotid Surgery?. Stroke Research and Treatment. 2011. Vol. 2012, no. 2012, pp.1-7.
https://search.emarefa.net/detail/BIM-450330
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-450330