Laser speckle contrast imaging of forehead cutaneous blood flow during carotid endarterectomy as a potential non-invasive method for surrogate monitoring of cerebral perfusion.
Mads J NiemannJonas P EibergHenrik SørensenNiels H SecherPublished in: Journal of clinical monitoring and computing (2020)
Monitoring cerebral perfusion is important for goal-directed anesthesia. Taking advantage of the supply of the supraorbital region and Glabella from the internal carotid artery (ICA), we evaluated changes in cutaneous blood flow using laser speckle contrast imagining (LSCI) as a potential method for indirect real-time monitoring of cerebral perfusion. Nine patients (8 men, mean age 70 years) underwent eversion carotid endarterectomy under local anesthesia. Cutaneous blood flow of the forehead was monitored using LSCI. During clamping of the common carotid artery (CCA), ipsilateral supraorbital region and Glabellas cutaneous blood flow dropped from 334 ± 135 to 221 ± 109 AU (p = 0.023) (AU: arbitrary flux units) and from 384 ± 151 to 276 ± 107 AU (p = 0.023), respectively, whilst the contralateral supraorbital region cutaneous blood flow remained unchanged. The supraorbital cutaneous blood flow did not change significantly following reperfusion of the external carotid artery (ECA) (221 ± 109 to 281 ± 154 AU; p = 0.175) and ICA (281 ± 154 to 310 ± 184 AU; p = 01). A comparable trend for Glabella followed ECA (276 ± 107 to 342 ± 170 AU; p = 0.404) and ICA (342 ± 170 to 352 ± 191 AU; p = 01) reperfusion. In patients undergoing carotid endarterectomy under local anesthesia, LSCI of the supraorbital and Glabella regions reflected clamping of the CCA but did not distinguish reperfusion of the ICA from that of the ECA.
Keyphrases
- blood flow
- sensitive detection
- reduced graphene oxide
- cerebral ischemia
- internal carotid artery
- subarachnoid hemorrhage
- contrast enhanced
- acute myocardial infarction
- magnetic resonance
- end stage renal disease
- visible light
- ejection fraction
- high resolution
- newly diagnosed
- magnetic resonance imaging
- brain injury
- middle cerebral artery
- peritoneal dialysis
- computed tomography
- acute coronary syndrome
- climate change
- percutaneous coronary intervention
- gold nanoparticles
- patient reported outcomes
- botulinum toxin
- risk assessment
- cerebral blood flow
- atrial fibrillation