Evaluation of extracranial—intracranial arterial bypass function by using near-infrared spectroscopy

2003 ◽  
Vol 99 (2) ◽  
pp. 304-310 ◽  
Author(s):  
Yoshihiro Murata ◽  
Yoichi Katayama ◽  
Kaoru Sakatani ◽  
Chikashi Fukaya ◽  
Tsuneo Kano
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Sensorimotor Cortex ◽  
Bypass Surgery ◽  
Near Infrared ◽  
Cutoff Value ◽  
Content Type ◽  
Arterial Bypass ◽  
Group Iii ◽  
Fine Print

Object. It has been reported that extracranial—intracranial (EC—IC) arterial bypass surgery can be useful in preventing stroke in patients with hemodynamic compromise. Little is yet known, however, regarding the extent to which the bypass contributes to maintaining adequate cerebral blood oxygenation (CBO) and its temporal changes following surgery. The authors evaluated bypass function repeatedly by using near-infrared spectroscopy (NIRS) after surgery. Methods. The authors investigated 30 patients who had undergone EC—IC bypass surgery. Single-photon emission computerized tomography revealed a decrease in regional cerebral blood flow (rCBF) and a lowered rCBF response to acetazolamide. Changes in CBO were evaluated in the sensorimotor cortex during compression of the anastomosed superficial temporal artery (STA). When decreases in oxyhemoglobin (HbO2) and total hemoglobin (Hb) concentrations were observed, the bypass was considered to have maintained CBO in the sensorimotor cortex given that decreases in HbO2 and total Hb indicate cerebral ischemic changes. The bypass maintained CBO immediately after surgery in 36.7% of patients (Group I, 11 patients) and at some time after surgery, mostly within 1 year, in 43.3% of patients (Group II, 13 patients); however, it did not maintain it throughout the follow-up period in 20% of patients (Group III, six patients). Note that the preoperative rCBF in patients in Groups I and II was lower than that in patients in Group III (p < 0.004). In fact, the preoperative rCBF predicted whether a bypass would maintain CBO at a cutoff value of 24.5 to 25 ml/100 g/min. Among Groups I and II, 18 patients demonstrated an increase in deoxyhemoglobin during STA compression. The preoperative rCBF in these cases was lower than that in the six remaining patients (p < 0.006). Note that the preoperative rCBF predicted the postoperative deoxyhemoglobin response at a cutoff value of 22.2 to 24 ml/100 g/min. Conclusions. The EC—IC bypass surgery can maintain CBO immediately after surgery or gradually within 1 year when the preoperative rCBF is below 24.5 to 25 ml/100 g/min. Furthermore, bypass flow plays a critical role in maintaining an adequate CBO when preoperative rCBF is below 22.2 to 24 ml/100 g/min.

Defining thresholds for critical ischemia by using near-infrared spectroscopy in the adult brain

1998 ◽  
Vol 89 (3) ◽  
pp. 389-394 ◽  
Author(s):  
Peter J. Kirkpatrick ◽  
Joseph Lam ◽  
Pippa Al-Rawi ◽  
Piotr Smielewski ◽  
Marek Czosnyka
Keyword(s):  
Infrared Spectroscopy ◽  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Adult Brain ◽  
Content Type ◽  
Signal Changes ◽  
Fine Print

Object. Signal changes in adult extracranial tissues may have a profound effect on cerebral near-infrared spectroscopy (NIRS) measurements. During carotid surgery NIRS signals provide the opportunity to determine the relative contributions from the intra- and extracranial vascular territories, allowing for a more accurate quantification. In this study the authors applied multimodal monitoring methods to patients undergoing carotid endarterectomy and explored the hypothesis that NIRS can define thresholds for cerebral ischemia, provided extracranial NIRS signal changes are identified and removed. Relative criteria for intraoperative severe cerebral ischemia (SCI) were applied to 103 patients undergoing carotid endarterectomy. Methods. One hundred three patients underwent carotid endarterectomy. An intraoperative fall in transcranial Doppler—detected middle cerebral artery flow velocity (%ΔFV) of greater than 60% accompanied by a sustained fall in cortical electrical activity were adopted as criteria for SCI. Ipsilateral frontal NIRS recorded the total difference in concentrations of oxyhemoglobin and deoxyhemoglobin (Total ΔHbdiff). Interrupted time series analysis following clamping of the external carotid artery (ECA) and the internal carotid artery (ICA) allowed the different vascular components of Total ΔHbdiff (ECA ΔHbdiff and ICA ΔHbdiff) to be identified. Data obtained in 76 patients were deemed suitable. A good correlation between %ΔFV and ICA ΔHbdiff (r = 0.73, p < 0.0001) was evident. Sixteen patients (21%) fulfilled the criteria for SCI. All patients who demonstrated an ICA ΔHbdiff of greater than 6.8 µmol/L showed SCI, and in two patients within this group nondisabling watershed infarction developed, as seen on postoperative computerized tomography scans. No patient with an ICA ΔHbdiff less than 5 µmol/L exhibited SCI or suffered a stroke. Within the resolution of the criteria used an ICA ΔHbdiff threshold of 6.8 µmol/L provided 100% specificity for SCI, whereas an ICA ΔHbdiff less than 5 µmol/L was 100% sensitive for excluding SCI. When Total ΔHbdiff was used without removing the ECA component, no thresholds for SCI were apparent. Conclusions. Carotid endarterectomy provides a stable environment for exploring NIRS-quantified thresholds for SCI in the adult head.

Comparison of two commercially available near-infrared spectroscopy instruments for cerebral oximetry

2000 ◽  
Vol 93 (2) ◽  
pp. 351-354 ◽  
Author(s):  
Hun Cho ◽  
Edwin M. Nemoto ◽  
Mark Sanders ◽  
Karl Fernandez ◽  
Howard Yonas
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Random Order ◽  
The United States ◽  
Cerebral Oximetry ◽  
Content Type ◽  
Arterial Blood ◽  
Fine Print

✓ Two near-infrared spectroscopy (NIRS) devices were compared with regard to their responses to changes in cerebral hemoglobin oxygenation induced by hypoxia and hypercapnia in five healthy volunteers.Sensors belonging to each NIRS device were placed on opposite sides of the volunteer's forehead. The INVOS3100A device, approved by the United States Food and Drug Administration, records the percentage of oxyhemoglobin (HbO2) saturation and the investigational NIRO500 device records absolute changes in HbO2, deoxyhemoglobin, and total hemoglobin in micromolar concentrations referenced to an arbitrary baseline. The volunteers breathed separate mixtures of 7% CO2 in O2 and 10% O2 for 5 minutes in random order. Arterial blood pressure, end-tidal CO2 (ETCO2), arterial O2 saturation, and electrocardiographic data were continuously monitored.Hypercapnia increased (p < 0.01) ETCO2 from 42 ± 2 to 56 ± 3 mm Hg (mean ± standard deviation), resulting in a 7.3 ± 0.2% increase (p < 0.005) in cerebral HbO2 saturation detected by the INVOS3100A device and an 11.6 ± 3 µM increase (p < 0.0008) in HbO2 detected by the NIRO500. Hypoxia decreased (p < 0.01) arterial HbO2 saturation from 98 ± 1 to 87 ± 3%, causing a 5.1 ± 1.2% decrease (p < 0.01) in the percentage of HbO2 saturation detected by the INVOS3100A device and a 9.7 ± 6.3 µM decrease in HbO2 detected by the NIRO500.The responses of the NIRO500 and the INVOS3100A instruments to changes in cerebral oxygenation resulting from hypercapnia and hypoxia were generally similar; however, responses tended to be greater when recorded by the NIRO500 device, perhaps because, unlike the INVOS3100A device, the NIRO500 does not correct for skin and bone contamination.

scholarly journals Study on driver’s braking intention identification based on functional near-infrared spectroscopy

2018 ◽  
Vol 1 (3) ◽  
pp. 107-113 ◽  
Author(s):  
Lei Zhu ◽  
Shuguang Li ◽  
Yaohua Li ◽  
Min Wang ◽  
Yanyu Li ◽  
...  
Keyword(s):  
Cerebral Cortex ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Driving Simulator ◽  
Intelligent System ◽  
Functional Near Infrared Spectroscopy ◽  
Content Type ◽  
Cooperative Driving ◽  
Intention Recognition

PurposeCooperative driving refers to a notion that intelligent system sharing controlling with human driver and completing driving task together. One of the key technologies is that the intelligent system can identify the driver’s driving intention in real time to implement consistent driving decisions. The purpose of this study is to establish a driver intention prediction model.Design/methodology/approachThe authors used the NIRx device to measure the cerebral cortex activities for identifying the driver’s braking intention. The experiment was carried out in a virtual reality environment. During the experiment, the driving simulator recorded the driving data and the functional near-infrared spectroscopy (fNIRS) device recorded the changes in hemoglobin concentration in the cerebral cortex. After the experiment, the driver’s braking intention identification model was established through the principal component analysis and back propagation neural network.FindingsThe research results showed that the accuracy of the model established in this paper was 80.39 per cent. And, the model could identify the driver’s braking intent prior to his braking operation.Research limitations/implicationsThe limitation of this study was that the experimental environment was ideal and did not consider the surrounding traffic. At the same time, other actions of the driver were not taken into account when establishing the braking intention recognition model. Besides, the verification results obtained in this paper could only reflect the results of a few drivers’ identification of braking intention.Practical implicationsThis study can be used as a reference for future research on driving intention through fNIRS, and it also has a positive effect on the research of brain-controlled driving. At the same time, it has developed new frontiers for intention recognition of cooperative driving.Social implicationsThis study explores new directions for future brain-controlled driving and wheelchairs.Originality/valueThe driver’s driving intention was predicted through the fNIRS device for the first time.

Feasibility of Intravascular Near-Infrared Spectroscopy in Off-Pump Myocardial Revascularization

2006 ◽  
Vol 1 (5) ◽  
pp. 258-262
Author(s):  
Franziska H. Bernet ◽  
Peter Matt ◽  
Hans-Reinhard Zerkowski ◽  
Doan Baykut
Keyword(s):  
Infrared Spectroscopy ◽  
Myocardial Ischemia ◽  
Near Infrared Spectroscopy ◽  
Coronary Sinus ◽  
Bypass Surgery ◽  
Near Infrared ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Off Pump ◽  
Coronary Sinus Blood

Objectives The intravascular application of near-infrared spectroscopy was previously evaluated in acute ischemia-reperfusion studies in animal experiments. The objective of our study was to assess the technical feasibility and clinical reliability of an online myocardial ischemia monitoring by using intravascular near-infrared spectroscopy during off-pump coronary bypass surgery. Methods Intravascular near-infrared spectroscopy of coronary sinus blood was performed in 10 elective patients selected for off-pump coronary bypass surgery. Light signals were transferred through a fiberoptic catheter for emission and collection from the coronary sinus blood. Spectrometric analyses were performed before and after revascularization with internal thoracic artery and saphenous vein grafts. Changes in spectroscopic data were compared with hemodynamic parameters and electrocardiographic, transesophageal echocardiographic, and laboratory findings. Results All of the operations were finished as off-pump procedures. No remarkable intraoperative myocardial ischemia was observed in the patient group, as indicated by electrocardiography and transesophageal echocardiography. Reproducible absorption spectra of coronary sinus blood were obtained at every defined step of the surgical procedure. Clear ischemia-related changes were detected in none of the patients. Conclusions Our initial results showed that intravascular near-infrared spectroscopic ischemia monitoring is technically feasible. However, the method must be further evaluated and standardized under varying conditions to determine the role of near-infrared spectroscopy as an ischemia monitoring tool in off-pump coronary bypass surgery.

scholarly journals Sensorimotor Cortex Activation during Mirror Therapy in Healthy Right-Handed Subjects: A Study with Near-Infrared Spectroscopy

2008 ◽  
Vol 20 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Itsuki Imai ◽  
Kotaro Takeda ◽  
Taizo Shiomi ◽  
Takamichi Taniguchi ◽  
Hiroyuki Kato
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Sensorimotor Cortex ◽  
Near Infrared ◽  
Mirror Therapy

Early detection of delayed traumatic intracranial hematomas using near-infrared spectroscopy

1995 ◽  
Vol 83 (3) ◽  
pp. 438-444 ◽  
Author(s):  
Shankar P. Gopinath ◽  
Claudia S. Robertson ◽  
Charles F. Contant ◽  
Raj K. Narayan ◽  
Robert G. Grossman ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Ct Scan ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Mass Effect ◽  
Intracerebral Hematoma ◽  
Secondary Brain Injury ◽  
Content Type ◽  
Postoperative Hematoma ◽  
Intracranial Hematomas

✓ Delayed intracranial hematomas are an important treatable cause of secondary brain injury in patients with head trauma. Early identification and treatment of these lesions, which appear or enlarge after the initial computerized tomography (CT) scan, may improve neurological outcome. Serial examinations using near-infrared spectroscopy (NIRS) to detect the development of delayed hematomas were performed in 167 patients. The difference in absorbance of light (ΔOD) at 760 nm between the normal and the hematoma side was measured serially during the first 3 days after injury. Twenty-seven (16%) of the patients developed a type of late hematoma: intracerebral hematoma in eight, extracerebral hematoma in six, and postoperative hematoma in 13 patients. Eighteen of the delayed hematomas caused significant mass effect and required surgical evacuation. The hematomas appeared between 2 and 72 hours after admission. In 24 of the 27 patients, a significant increase (> 0.3) in the ΔOD occurred prior to an increase in intracranial pressure, a change in the neurological examination, or a change on CT scan. A favorable outcome occurred in 67% of the patients with delayed hematomas, which suggests that early diagnosis using NIRS may allow early treatment and reduce secondary injury caused by delayed hematomas.

Intraoperative control of extracranial—intracranial bypass patency by near-infrared indocyanine green videoangiography

2005 ◽  
Vol 102 (4) ◽  
pp. 692-698 ◽  
Author(s):  
Johannes Woitzik ◽  
Peter Horn ◽  
Peter Vajkoczy ◽  
Peter Schmiedek
Keyword(s):  
Indocyanine Green ◽  
Ct Angiography ◽  
Bypass Surgery ◽  
Near Infrared ◽  
Bypass Graft ◽  
High Flow ◽  
Indocyanine Green Videoangiography ◽  
Content Type ◽  
Bypass Patency ◽  
Fine Print

Object. Recently, intraoperative fluorescence angiography in which indocyanine green (ICG) is used as a tracer has been introduced as a novel technique to confirm successful aneurysm clipping. The aim of the present study was to assess whether ICG videoangiography is also suitable for intraoperative confirmation of extracranial—intracranial bypass patency. Methods. Forty patients undergoing cerebral revascularization for hemodynamic cerebral ischemia (11 patients), moyamoya disease (18 patients), or complex intracranial aneurysms (11 patients) were included. Superficial temporal artery (STA)—middle cerebral artery (MCA) bypass surgery was performed 35 times in 30 patients (five patients with moyamoya underwent bilateral procedures), STA—posterior cerebral artery bypass surgery in two patients, and saphenous vein (SV) high-flow bypass surgery in eight patients. In each patient, following the completion of the anastomosis, ICG (0.3 mg/kg body weight) was given systemically via an intravenous bolus injection. A near-infrared light emitted by laser diodes was used to illuminate the operating field and the intravascular fluorescence was recorded using an optical filter—equipped video camera. The findings of ICG videoangiography were compared with those of postoperative digital subtraction (DS) or computerized tomography (CT) angiography. In all cases excellent visualization of cerebral arteries, the bypass graft, and brain perfusion was noted. Indocyanine green videoangiography was used to identify four nonfunctioning STA—MCA bypasses, which could be revised successfully in all cases. In two cases of SV high-flow bypasses, ICG videoangiography revealed stenosis at the proximal anastomotic site, which was also revised successfully. In all cases the final findings of ICG videoangiography could be positively validated during the postoperative course by performing DS or CT angiography. Conclusions. Indocyanine green videoangiography provides a reliable and rapid intraoperative assessment of bypass patency. Thus, ICG videoangiography may help reduce the incidence of early bypass graft failure.

scholarly journals Functional Lateralization of Sensorimotor Cortex in Infants Measured Using Multichannel Near-Infrared Spectroscopy

2011 ◽  
Vol 69 (5 Part 1) ◽  
pp. 430-435 ◽  
Author(s):  
TAKASHI KUSAKA ◽  
KENICHI ISOBE ◽  
TAKANORI MIKI ◽  
MASAKI UENO ◽  
KOSUKE KOYANO ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Sensorimotor Cortex ◽  
Near Infrared ◽  
Functional Lateralization
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