TY - JOUR
T1 - Usefulness of regional cerebral oxygen saturation monitoring in balloon test occlusion
AU - Niizuma, Kuniyasu
AU - Kamii, Hideyuki
AU - Matsumoto, Yasushi
AU - Kondoh, Ryushi
AU - Shimizu, Hiroaki
AU - Tominaga, Teiji
PY - 2006/7
Y1 - 2006/7
N2 - Purpose: Recently, temporary balloon test occlusion (BTO) of the internal carotid artery (IC) has become a well accepted procedure for preoperative evaluation of patients with IC large aneurysms. However, it might be dangerous to move patients fitted with a balloon catheter to the room for single-photon emission computed tomography (SPECT). We attempted to clarify the usefulness of regional cerebral oxygen saturation (rSO 2) monitoring during BTO, comparing cerebral blood flow (CBF) obtained from SPECT. Materials and Methods: Eight patients with an IC large aneurysm underwent BTO with rSO 2 monitoring. Regions of interest in the SPECT were denned in the area below the rSO 2 sensor of each hemisphere. Correlations among rSO 2, CBF, stump pressure and appearance of symptoms were discussed. Results: The rSO 2 significantly reduced during BTO (74.1 ± 1.2 to 60.4 ± 2.7%, p<0.001). The individual decreases in rSO 2 correlated with decreases of CBF from SPECT (r=0.966, P<0.001). Four patients with ArSO 2 (baseline rSO 2 - rSO 2 during IC occlusion) less than 12 points had no symptoms, but 4 patients with ArSO 2 more than 14 points had some symptoms. The stump pressure had no correlation with CBF and rSO 2. Conclusions: The rSO 2 significantly correlated with CBF from SPECT and related with appearance of symptoms. Our results revealed that rSO 2 monitoring was useful in BTO, and SPECT could be skipped in some cases to determine the strategies for treatment of IC large aneurysms.
AB - Purpose: Recently, temporary balloon test occlusion (BTO) of the internal carotid artery (IC) has become a well accepted procedure for preoperative evaluation of patients with IC large aneurysms. However, it might be dangerous to move patients fitted with a balloon catheter to the room for single-photon emission computed tomography (SPECT). We attempted to clarify the usefulness of regional cerebral oxygen saturation (rSO 2) monitoring during BTO, comparing cerebral blood flow (CBF) obtained from SPECT. Materials and Methods: Eight patients with an IC large aneurysm underwent BTO with rSO 2 monitoring. Regions of interest in the SPECT were denned in the area below the rSO 2 sensor of each hemisphere. Correlations among rSO 2, CBF, stump pressure and appearance of symptoms were discussed. Results: The rSO 2 significantly reduced during BTO (74.1 ± 1.2 to 60.4 ± 2.7%, p<0.001). The individual decreases in rSO 2 correlated with decreases of CBF from SPECT (r=0.966, P<0.001). Four patients with ArSO 2 (baseline rSO 2 - rSO 2 during IC occlusion) less than 12 points had no symptoms, but 4 patients with ArSO 2 more than 14 points had some symptoms. The stump pressure had no correlation with CBF and rSO 2. Conclusions: The rSO 2 significantly correlated with CBF from SPECT and related with appearance of symptoms. Our results revealed that rSO 2 monitoring was useful in BTO, and SPECT could be skipped in some cases to determine the strategies for treatment of IC large aneurysms.
KW - Balloon test occlusion
KW - Cerebral blood flow
KW - Giant aneurysm
KW - Regional cerebral oxygen saturation
KW - Single photon emission computed tomography
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M3 - Article
C2 - 16841705
AN - SCOPUS:33745740130
SN - 0301-2603
VL - 34
SP - 605
EP - 702
JO - Neurological Surgery
JF - Neurological Surgery
IS - 7
ER -