Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-28T11:12:26.085Z Has data issue: false hasContentIssue false

27 - Near infrared spectroscopy in carotid endarterectomy

from Monitoring the local and distal effects of carotid interventions

Published online by Cambridge University Press:  03 December 2009

Pippa G. Al-Rawi
Affiliation:
Addenbrooke's Hospital, Cambridge, UK
Peter J. Kirkpatrick
Affiliation:
Addenbrooke's Hospital, Cambridge, UK
Jonathan Gillard
Affiliation:
University of Cambridge
Martin Graves
Affiliation:
University of Cambridge
Thomas Hatsukami
Affiliation:
University of Washington
Chun Yuan
Affiliation:
University of Washington
Get access

Summary

Introduction

The use of in vivo tissue near infrared spectroscopy (NIRS) in humans was first described more than 25 years ago by F. F. Jöbsis (Jöbsis, 1977). The technique is based on the concept that light of wavelengths 680–1000 nm is able to penetrate human tissue and is absorbed by the chromophores oxyhemoglobin (HbO2), deoxyhemoglobin (Hb) and cytochrome oxidase. Changes in the detected light levels can therefore represent changes in concentrations of these chromophores. The noninvasive nature of the technique led to its first clinical application for monitoring the cerebral oxygenation status of premature infants (Brazy et al., 1985). Since then it has become an established research tool with numerous applications (Ferrari et al., 1986; Brown et al., 1993; Aldrich et al., 1994; Villringer et al., 1994; Lam et al., 1996; Elwell et al., 1997; Tamura et al., 1997; Nollert et al., 2000; Watanabe et al., 2002; Vernieri et al., 2004).

Whilst its clinical use for monitoring the brain has been well established in neonates, where transillumination is possible due to the thin skull and small dimensions, clinical application of NIRS for monitoring the adult brain has been hampered by the fact that it must be applied in reflectance mode (Young et al., 2000).

Type
Chapter
Information
Carotid Disease
The Role of Imaging in Diagnosis and Management
, pp. 372 - 386
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al-Rawi, P. G., Smielewski, P. and Kirkpatrick, P. J. (2001). Evaluation of a near infrared spectrometer (NIRO 300) for the detection of intracranial oxygenation changes in the adult head. Stroke, 32, 2492–500.CrossRefGoogle ScholarPubMed
Al-Rawi, P. G., and Kirkpatrick, P. J. Tissue Oxygen Index (TOI): Thresholds for cerebral ischaemia using infrared spectroscopy. Stroke, in press.
Al-Rawi, P. G., Smielewski, P., Hobbiger, H., Ghosh, S. and Kirkpatrick, P. J. (1999). Assessment of spatially resolved spectroscopy during cardiopulmonary bypass. Journal of Biomedical Optics, 4, 208–16.CrossRefGoogle ScholarPubMed
Aldrich, C. J., D'Antona, D., Wyatt, J. S., et al. (1994). Fetal cerebral oxygenation measured by near infrared spectroscopy shortly before birth and acid-base status at birth. Obstetrics and Gynaecology, 84, 861–6.Google ScholarPubMed
Beese, U., Langer, H., Lang, W. and Dinkel, M. (1998). Comparison of near-infrared spectroscopy and somatosensory evoked potentials for the detection of cerebral ischaemia during carotid endarterectomy. Stroke, 29, 2032–7.CrossRefGoogle ScholarPubMed
Brazy, J. E., Lewis, D. V., Mitnik, M. H. and Jöbsis, F. F. (1985). Non invasive monitoring of cerebral oxygenation in preterm infants: preliminary observations. Paediatrics, 75, 217–25.Google Scholar
Brown, R., Wright, G. and Royston, D. (1993). A comparison of two systems for assessing cerebral venous oxyhaemoglobin saturation during cardiopulmonary bypass in humans. Anaesthesia, 48, 697–700.CrossRefGoogle ScholarPubMed
Carlin, R. E., McGraw, D. J., Calimlim, J. R. and Mascia, M. F. (1998). The use of near-infrared cerebral oximetry in awake carotid endarterectomy. Journal of Clinical Anesthesia, 10, 109–13.CrossRefGoogle ScholarPubMed
Chan, K.-H., Miller, J. D., Dearden, N. M., Andrews, P. J. D. and Midgley, S. (1992). The effect of changes in cerebral perfusion pressure upon middle cerebral artery blood flow velocity and jugular bulb venous oxygen saturation after severe brain injury. Journal of Neurosurgery, 77, 55–61.CrossRefGoogle ScholarPubMed
Cheng, M. A., Theard, M. A. and Tempelhoff, R. (1997). Anesthesia for carotid endarterectomy: a survey. Journal of Neurosurgical Anaesthesiology, 9, 211–16.CrossRefGoogle ScholarPubMed
Cope, M. and Delpy, D. T. (1988). System for long-term measurement of cerebral blood and tissue oxygenation on newborn infants by near infra-red transillumination. Medical and Biological Engineering and Computing, 26, 289–94.CrossRefGoogle ScholarPubMed
Czosnyka, M., Whitehouse, H., Smielewski, P., et al. (1994). Computer supported multimodal bed-side monitoring for neuro intensive care. Journal of Clinical Monitoring and Computing, 11, 223–32.CrossRefGoogle ScholarPubMed
Dehghani, H. and Delpy, D. T. (2000). Near infrared spectroscopy of the adult head: effect of scattering and absorbing obstructions in the CSF layer on light distribution in the tissue. Applied Optics, 39, 4721–9.CrossRefGoogle ScholarPubMed
Delpy, D. T. and Cope, M. (1997). Quantification in tissue near-infrared spectroscopy. Philosophical Transactions of the Royal Society of London. Series B, 352, 649–59.CrossRefGoogle Scholar
Delpy, D. T., Cope, M., Zee, P., et al. (1988). Estimation of optical pathlength through tissue from direct time of flight measurement. Physics in Medicine and Biology, 33, 1433–42.CrossRefGoogle ScholarPubMed
du Plessis, A. J., Newburger, J., Jonas, R. A., et al. (1995). Cerebral oxygenation supply and utilisation during infarct cardiac surgery. Annals of Neurology, 37, 488–97.CrossRefGoogle Scholar
Duffy, C. M., Manninen, P. H., Chan, A. and Kearns, C. F. (1997). Comparison of cerebral oximeter and evoked potential monitoring in carotid endarterectomy. Canadian Journal of Anaesthesia, 44, 1077–81.CrossRefGoogle ScholarPubMed
Dullenkopf, A., Frey, B., Baenziger, O., Gerber, A. and Weiss, M. (2003). Measurement of cerebral oxygenation state in anaesthetized children using the INVOS 5100 cerebral oximeter. Paediatric Anaesthesia, 13, 384–91.CrossRefGoogle Scholar
Elwell, C. E., Matcher, S. J., Tyszczuk, L., Meek, J. H. and Delpy, D. T. (1997). Measurement of cerebral venous saturation in adults using near infrared spectroscopy. Advances in Experimental Medicine and Biology, 411, 453–60.CrossRefGoogle ScholarPubMed
Fantini, S., Franceschini, M. A., Maier, J. S., et al. (1995). Frequency-domain multichannel optical detector for non-invasive tissue spectroscopy and oximetry. Optical Engineering, 34, 32–42.CrossRefGoogle Scholar
Ferrari, M., Marchis, C. and Giannini, I. (1986). Cerebral blood volume and haemoglobin oxygen saturation monitoring in the neonatal brain by near infrared spectroscopy. Advances in Experimental Medicine and Biology, 200, 203–11.CrossRefGoogle Scholar
Firbank, M., Schweiger, M. and Delpy, D. T. (1995). Investigation of light piping through clear regions of scattering objects. Proceedings of SPIE, 2389, 167–73.CrossRefGoogle Scholar
Germon, T. J., Evans, D. H., Barnett, N., et al. (1999). Cerebral near infrared spectroscopy: emitter-detector separation must be increased. British Journal of Anaesthesia, 82, 831–7.CrossRefGoogle ScholarPubMed
Germon, T. J., Kane, N. M., Manara, A. R. and Nelson, R. J. (1994). Near-infrared spectroscopy in adults: effects of extracranial ischaemia and intracranial hypoxia on estimation of cerebral oxygenation. British Journal of Anaesthesia, 73, 503–6.CrossRefGoogle ScholarPubMed
Germon, T. J., Young, A. E. R., Manara, A. R., et al. (1995). Extracerebral absorption of near infrared light influences the detection of increased cerebral oxygen monitored by near infrared spectroscopy. Journal of Neurology, Neurosurgery and Psychiatry, 58, 477–9.CrossRefGoogle ScholarPubMed
Graham, A. M., Gewetz, B. L. and Zarins, C. K. (1986). Predicting cerebral ischaemia during carotid endarterectomy. Archives of Surgery, 121, 595–8.CrossRefGoogle ScholarPubMed
Harris, D. N. and Bailey, S. M. (1993). Near infrared spectroscopy in adults. Does the INVOS 3100 really measure intracerebral oxygenation?Anaesthesia, 48, 694–6.CrossRefGoogle ScholarPubMed
Harris, D. N., Cowans, F. M. and Wertheim, D. A. (1994). Near infrared spectroscopy in the temporal region: strong influence of external carotid artery. Advances in Experimental Medicine and Biology, 345, 825–8.CrossRefGoogle Scholar
Hazeki, O. and Tamura, M. (1988). Quantitative analysis of haemoglobin oxygenation state of brain in situ by near-infrared spectrophotometry. Journal of Applied Physiology, 64, 796–802.CrossRefGoogle ScholarPubMed
Hiraoka, M., Firbank, M. and Essenpries, M. (1993). A Monte Carlo investigation of optical pathlength in inhomogeneous tissue and its application to near infrared spectroscopy. Physics in Medicine and Biology, 38, 1859–76.CrossRefGoogle ScholarPubMed
Hirofumi, O., Otone, E., Hiroshi, I., et al. (2003). The effectiveness of regional cerebral oxygen saturation monitoring using near-infrared spectroscopy in carotid endarterectomy. Journal of Clinical Neuroscience, 10, 79–83.CrossRefGoogle ScholarPubMed
Jorgensen, L. G. and Schroeder, T. V. (1992). Transcranial Doppler for detection of cerebral ischemia during carotid endarterectomy. European Journal of Vascular Surgery, 6, 142–7.CrossRefGoogle ScholarPubMed
Jöbsis, F. F. (1977). Non-invasive infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science, 198, 1264–7.CrossRefGoogle Scholar
Kirkpatrick, P. J., Smielewski, P., Al-Rawi, P. and Czosnyka, M. (1998a). Resolving extra- and intracranial signal changes during adult near infrared spectroscopy. Neurological Research, 20, S19–S22.CrossRefGoogle Scholar
Kirkpatrick, P. J., Lam, J. M. K., Al-Rawi, P. G., Smielewski, P. and Czosnyka, M. (1998b). Defining thresholds for critical ischaemia by using near-infrared spectroscopy in the adult brain. Journal of Neurosurgery, 89, 389–94.CrossRefGoogle Scholar
Kirkpatrick, P. J., Smielewski, P., Czosnyka, M., Menon, D. K. and Pickard, J. D. (1995a). Near infrared spectroscopy use in patients with head injury. Journal of Neurosurgery, 83, 963–70.CrossRefGoogle Scholar
Kirkpatrick, P. J., Smielewski, P., Whitfield, P., et al. (1995b). An observational study of near infrared spectroscopy during carotid endarterectomy. Journal of Neurosurgery, 82, 756–63.CrossRefGoogle Scholar
Kirkpatrick, P. J., Smielewski, P., Lam, J. M. K. and Al-Rawi, P. G. (1996). Use of near infrared spectroscopy for the clinical monitoring of adult brain. Journal of Biomedical Optics, 1, 363–72.CrossRefGoogle ScholarPubMed
Komiyama, T., Quaresima, V., Shigematsu, H. and Ferrari, M. (2001). Comparison of two spatially resolved near-infrared photometers in the detection of tissue oxygen saturation: poor reliability at very low oxygen saturation. Clinical Science, 101, 715–18.CrossRefGoogle ScholarPubMed
Kuroda, S., Houkin, K., Abe, H., Hoshi, Y. and Tamura, M. (1996). Near-infrared monitoring of cerebral oxygenation state during carotid endarterectomy. Surgical Neurology, 45, 450–8.CrossRefGoogle ScholarPubMed
Kurth, C. D., Steven, J. M. and Nicholson, S. C. (1995). Cerebral oxygenation during pediatric surgery using deep hypothermic circulatory arrest. Anaesthesiology, 82, 74–82.CrossRefGoogle ScholarPubMed
Kytta, J., Ohman, J., Tanskanen, P. and Randell, T. (1999). Extracranial contribution to cerebral oximetry in brain dead patients: a report of six cases. Journal of Neurosurgical Anaesthesiology, 11, 252–4.CrossRefGoogle ScholarPubMed
Lam, J. M. K., Kirkpatrick, P. J., Al-Rawi, P., Smielewski, P. and Pickard, J. D. (1996). Internal and external carotid contribution to near infrared spectroscopy (NIRS) during carotid endarterectomy (CE). Journal of Neurology, Neurosurgery and Psychiatry, 61, 553.Google Scholar
Lam, J. M. K., Smielewski, P., Al-Rawi, P., et al. (1997). Internal and external carotid contributions to near-infrared spectroscopy during carotid endarterectomy. Stroke, 28, 906–11.CrossRefGoogle ScholarPubMed
Liem, K. D., Hopman, J. C. W., Oeseburg, B., et al. (1995). Cerebral oxygenation and haemodynamics during induction of extracorporeal membrane oxygenation as investigated by near infrared spectroscopy. Paediatrics, 95, 555–61.Google Scholar
Litscher, G. and Schwarz, G. (1997). Transcranial cerebral oximetry – is it clinically useless at this moment to interpret absolute values obtained by the INVOS 3100 cerebral oximeter?Biomedizinische Technik, 42, 74–7.CrossRefGoogle ScholarPubMed
Matcher, S. J., Kirkpatrick, P. J., Nahid, K., Cope, M. and Delpy, D. T. (1993). Absolute quantification methods in tissue near infrared spectroscopy. Proceedings of SPIE, 2389, 486–95.CrossRefGoogle Scholar
McKeating, E. G., Monjardino, J. R., Signorini, D. F., Souter, M. J. and Andrews, P. J. D. (1997). A comparison of the INVOS 3100 and the Critikon 2020 near-infrared spectrophotometer as monitors of cerebral oxygenation. Anaesthesia, 52, 136–40.CrossRefGoogle Scholar
Mille, T., Tachimiri, M. E., Klersy, C., et al. (2004). Near infrared spectroscopy monitoring during carotid endarterectomy: which threshold value is critical?European Journal of Vascular and Endovascular Surgery, 27, 646–50.CrossRefGoogle ScholarPubMed
Miwa, M., Ueda, Y. and Chance, B. (1995). Development of time resolved spectroscopy system for quantitative non-invasive tissue measurement. Proceedings of SPIE, 2389, 142–9.CrossRefGoogle Scholar
Nollert, G., Jonas, R. A. and Reichart, B. (2000). Optimising cerebral oxygenation during cardiac surgery: a review of experimental and clinical investigations with near infrared spectrophotometry. Thoracic and Cardiovascular Surgeon, 48, 247–53.CrossRefGoogle Scholar
Oda, M., Yamashita, Y., Nishimura, G. and Tamura, M. (1996). A simple and novel algorithm for time resolved multiwavelength oximetry. Physics in Medicine and Biology, 40, 2093–108.Google Scholar
Okada, E., Firbank, M., Schweiger, M., et al. (1995). A theoretical and experimental investigation of the effect of sulci on light propagation in brain tissue. Proceedings of SPIE, 2626, 2–8.CrossRefGoogle Scholar
Okada, E., Firbank, M., Schweiger, M., et al. (1997). Theoretical and experimental investigation of near-infrared light propagation in a model of the adult head. Applied Optics, 36, 21–31.CrossRefGoogle Scholar
Patterson, M. S., Chance, B. and Wilson, B. C. (1989). Time resolved reflectance and transmittance for the noninvasive measurement of tissue optical properties. Applied Optics, 28, 2331–6.CrossRefGoogle Scholar
Piantadosi, C. A. (1989). Near infrared spectroscopy: principles and application to non-invasive assessment of tissue oxygenation. Journal of Critical Care, 4, 308–18.CrossRefGoogle Scholar
Samra, S. K., Dorje, P., Zelenock, G. B. and Stanley, J. C. (1996). Cerebral oximetry in patients undergoing carotid endarterectomy under regional anaesthesia. Stroke, 27, 49–55.CrossRefGoogle Scholar
Samra, S. K., Dy, E. A., Welch, K., et al. (2000). Evaluation of a cerebral oximeter as a monitor of cerebral ischaemia during carotid endarterectomy. Anaesthesiology, 93, 970.CrossRefGoogle ScholarPubMed
Schwarz, G., Litscher, G., Kleinert, R. and Jobstmann, R. (1996). Cerebral oximetry in dead subjects. Journal of Neurosurgical Anesthesiology, 8, 189–93.CrossRefGoogle ScholarPubMed
Smielewski, P., Czosnyka, M., Zabolotny, W., et al. (1997). A computing system for the clinical and experimental investigation of cerebrovascular reactivity. International Journal of Clinical Monitoring and Computing, 14, 185–98.CrossRefGoogle ScholarPubMed
Suzuki, S., Takasaki, S., Ozaki, T. and Kobayashi, Y. (1999). A tissue oxygenation monitor using NIR spatially resolved spectroscopy. Proceedings of SPIE, 3597, 582–92.CrossRefGoogle Scholar
Tamura, M., Hoshi, Y. and Okada, F. (1997). Localised near-infrared spectroscopy and functional optical imaging of brain activity. Philosophical Transactions of the Royal Society of London. Series B, 352, 737–42.CrossRefGoogle Scholar
Vernieri, F., Tibuzzi, F., Pasqualetti, P., et al. (2004). Transcranial Doppler and near-infrared spectroscopy can evaluate the haemodynamic effect of carotid artery occlusion. Stroke, 35, 64–70.CrossRefGoogle ScholarPubMed
Villringer, A., Planck, J., Stodieck, S., et al. (1994). Non invasive assessment of cerebral haemodynamics and tissue oxygenation during activation of brain function in human adults using near infrared spectroscopy. Advances in Experimental Medicine and Biology, 345, 559–65.CrossRefGoogle Scholar
Watanabe, E., Nagahori, Y. and Mayanagi, Y. (2002). Focus diagnosis of epilepsy using near-infrared spectroscopy. Epilepsia, 43 (Suppl. 9), 50–5.CrossRefGoogle ScholarPubMed
Williams, I. M., Mead, G., Picton, A. J., et al. (1995). The influence of contralateral carotid stenosis and occlusion on cerebral oxygen saturation during carotid artery surgery. European Journal of Vascular and Endovascular Surgery, 10, 198–206.CrossRefGoogle ScholarPubMed
Williams, I. M., Picton, A., Farrell, A., et al. (1994a). Light reflective cerebral oximetry and jugular bulb venous oxygen saturation during carotid endarterectomy. British Journal of Surgery, 81, 1291–5.CrossRefGoogle Scholar
Williams, I. M., Vohra, R., Farrell, A., et al. (1994b). Cerebral oxygen saturation, transcranial Doppler ultrasonography and stump pressure in carotid surgery. British Journal of Surgery, 81, 960–4.CrossRefGoogle Scholar
Wray, S., Cope, M., Delpy, D. T., Wyatt, J. S. and Reynolds, E. O. R. (1988). Characterisation of the near infrared absorption spectra of cytochrome aa3 and haemoglobin for the non-invasive monitoring of cerebral oxygenation. Biochimica et Biophysica Acta, 933, 184–92.CrossRefGoogle Scholar
Wyatt, J. S., Cope, M., Delpy, D. T., et al. (1990). Quantification of cerebral blood volume in newborn infants by near infrared spectroscopy. Journal of Applied Physiology, 68, 1086–91.CrossRefGoogle Scholar
Yoshitani, K., Kawaguchi, M., Tatsumi, K., Kitaguchi, K. and Furuya, H. (2002). A comparison of the INVOS 4100 and the NIRO 300 near-infrared spectrometers. Anesthesia and Analgesia, 94, 586–90.CrossRefGoogle Scholar
Young, A. E. R., Germon, T. J., Barnett, N. J., Manara, A. R. and Nelson, R. J. (2000). Behaviour of near-infrared light in the adult human head: implications for clinical near-infrared spectroscopy. British Journal of Anaesthesia, 84, 38–42.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×