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

• Material Type: 博士論文
• Title: Amplitude of Tissue Oxygenation Index Change Predicts Cerebral Hyperperfusion Syndrome During Carotid Artery Stenting.
• Author/Editor: Park, Hun Soo; Nakagawa, Ichiro; Yokoyama, Shohei; Motoyama, Yasushi; Park, Young Su; Wada, Takeshi; Kichikawa, Kimihiko; Nakase, Hiroyuki
• Author Heading: Park, Hun Soo; Nakagawa, Ichiro; Yokoyama, Shohei; Motoyama, Yasushi; Park, Young Su; Wada, Takeshi; Kichikawa, Kimihiko; Nakase, Hiroyuki
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2017-03
• Publication Date (W3CDTF): 2017-03
• Alternative Title: 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
• Periodical title: World neurosurgery
• No. or year of volume/issue: 99
• Volume: 99
• Pages: 548-555
• ISSN (Periodical Title): ISSN : 1878-8750
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2019-09-27
• Dissertation Number: 乙第1439号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Carotid artery stenting; Hyperperfusion syndrome; Near-infrared spectroscopy
• Target Audience: 一般
• Note (General): 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
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.wneu.2016.12.062
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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