Amplitude of Tissue Oxygenation Index Change Predicts Cerebral Hyperperfusion Syndrome During Carotid Artery Stenting.

• 資料種別: 博士論文
• ISSN: 1878-8750
• タイトル: Amplitude of Tissue Oxygenation Index Change Predicts Cerebral Hyperperfusion Syndrome During Carotid Artery Stenting.
• 巻次・部編番号: 99
• 著者・編者: Park, Hun Soo; Nakagawa, Ichiro; Yokoyama, Shohei; Motoyama, Yasushi; Park, Young Su; Wada, Takeshi; Kichikawa, Kimihiko; Nakase, Hiroyuki
• 著者標目: Park, Hun Soo; Nakagawa, Ichiro; Yokoyama, Shohei; Motoyama, Yasushi; Park, Young Su; Wada, Takeshi; Kichikawa, Kimihiko; Nakase, Hiroyuki
• 出版事項: Elsevier
• 出版年月日等: 2017-03; 99
• 出版年（W3CDTF）: 2017-03
• 並列タイトル等: 頸動脈ステント留置術周術期における脳組織酸素化指数を用いた術後過灌流予測
• タイトル（掲載誌）: World neurosurgery
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2019-09-27
• 授与年月日（W3CDTF）: 2019-09-27
• 報告番号: 乙第1439号
• 学位: 博士（医学）
• 博論授与番号: 乙第1439号
• 本文の言語コード: eng
• 件名標目: Carotid artery stenting; Hyperperfusion syndrome; Near-infrared spectroscopy
• 対象利用者: 一般
• 一般注記: type:Thesis; OBJECTIVE: Hyperperfusion syndrome (HPS) after carotid artery stenting (CAS) is a rare but serious complication. HPS is associated with preoperative hemodynamic impairment as the result of poor collateral flow and intraoperative cerebral ischemia. Filter-type embolic protection devices maintain anterograde carotid flow during CAS and prevent HPS somewhat. The early treatment of patients undergoing CAS and at risk for HPS is essential. Near-infrared spectroscopy allows noninvasive, real-time measurement of frontal lobe regional cerebral O2 saturation (TOI; tissue oxygenation index). METHODS: The perioperative amplitude of TOI was monitored in 130 patients undergoing CAS while using a filter-type embolic protection device. Patients were divided retrospectively into good (n = 110) and poor/no crossflow groups (n = 20), and we compared the amplitude of the TOI change, correlation with ipsilateral regional cerebral blood flow, and clinical results. RESULTS: The incidence of HPS was significantly greater in the poor/no crossflow group (P = 0.019). In 2 patients with HPS, the amplitude of the TOI change was V-shaped, with a decrease after postdilatation and an increase above baseline 5 minutes after reperfusion. The TOI/baseline ratio was significantly decreased after internal carotid artery occlusion for postdilatation in the ipsilateral hemisphere in the poor/no crossflow group (P < 0.05). Significant linear correlations were observed between TOI/baseline ratio changes and preoperative cerebrovascular reactivity and the postoperative asymmetry index (r = -0.346, P = 0.002, r = 0.613, P < 0.001, respectively). CONCLUSIONS: The amplitude of the TOI change measured by near-infrared spectroscopy was an excellent predictor of cerebral HPS after CAS.; 博士（医学）・乙第1439号・令和元年9月27日; Copyright © 2016 Elsevier Inc. All rights reserved.; identifier:World neurosurgery Vol.99 p.548-555 (2017 Mar); identifier:18788750; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3675; identifier:World neurosurgery, 99: 548-555
• DOI: info:doi/10.1016/j.wneu.2016.12.062; https://doi.org/info:doi/10.1016/j.wneu.2016.12.062
• 国立国会図書館永続的識別子: info:ndljp/pid/11490430; https://dl.ndl.go.jp/pid/11490430
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2020-05-25T09:38:44+09:00
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://hdl.handle.net/10564/3675
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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