Regional cerebral blood flow measurement using near-infrared spectroscopy with indocyanine green during carotid artery stenting—Efficacy for evaluation of hyperperfusion syndrome—

Abstract

The purpose of this study was to evaluate the feasibility of regional cerebral blood flow monitoring using near-infrared spectroscopy (NIRS) and indocyanine green (ICG) as an intravascular tracer in carotid artery stenting (CAS) with a filter protection device. Thirty four patients underwent CAS under local anesthesia. We assessed the change of blood flow index (BFI) and mean transit time (MTT) parameter measured by NIRO 200NX (Hamamatsu Photonics) during CAS procedure. Angiographic success was obtained in all procedure. Two patients presented hyperperfusion syndrome and they managed under sedation and hypotension therapy by reference to NIRS values. There were no major/minor embolic strokes and intracranial hemorrhage associated with hyperperfusion syndrome. BFI ratio was increased and MTT ratio was shortened after stent placement in HPS group compared with non HPS group. These results suggest that NIRS using ICG as a intravascular tracer can provide valuable information on cerebral hemodynamic changes during perioperative management.