| Title | Intraoperative monitoring of cerebral blood flow by laser speckle contrast analysis. | | Author(s) | Hecht N, Woitzik J, Dreier JP, Vajkoczy P | | Institution | Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, Germany. | | Source | Neurosurg Focus 2009 Oct; 27(4):E11. | | MeSH | Adult
Aged
Anastomosis, Surgical
Blood Flow Velocity
Cerebral Cortex
Cerebral Revascularization
Cerebrovascular Circulation
Cerebrovascular Disorders
Feasibility Studies
Female
Humans
Image Enhancement
Image Interpretation, Computer-Assisted
Intracranial Aneurysm
Laser-Doppler Flowmetry
Lasers
Male
Middle Aged
Monitoring, Intraoperative
Radial Artery
Vascular Patency
| | Abstract | OBJECT: Currently, reliable low-cost and noninvasive techniques to assess cerebral perfusion in the operating room are not available. The authors report on their first clinical experience with laser speckle contrast analysis (LASCA) as a complementary imaging tool for the noninvasive and dynamic assessment of cerebral blood flow (CBF) during neurovascular surgery. The purpose of this preliminary study was to address the general feasibility of LASCA in terms of handling and image quality and to provide an example of its clinical implications.
METHODS: Laser speckle contrast analysis was performed in patients undergoing cerebral revascularization procedures for the treatment of hemodynamic compromise and complex aneurysms. The portable LASCA device was centered over the surgical field, and continuous 5-minute recordings of relative CBF were obtained. In the case of flow augmentation for hemodynamic compromise, CBF monitoring was performed before and after completion of the anastomosis. In the case of flow replacement for parent artery sacrifice, CBF monitoring was performed during consecutive 30-second test occlusions of the radial artery graft after proximal internal carotid artery sacrifice and the subsequent initiation of blood flow through the bypass.
RESULTS: In all cases, the authors achieved good visualization of relative CBF in addition to flow imaging in both the bypass graft and the cortical vasculature. During a sudden CBF decrease after test occlusion of the radial artery graft and subsequent flow initiation through the bypass, LASCA allowed immediate visualization and measurement of relative CBF in excellent spatiotemporal resolution.
CONCLUSIONS: In this study LASCA offered noninvasive and rapid intraoperative assessment of relative CBF, which can be used for optimizing neurovascular procedures. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 19795950 |
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