Usefulness of regional cerebral oxygen saturation monitoring in balloon test occlusion

Kuniyasu Niizuma, Hideyuki Kamii, Yasushi Matsumoto, Ryushi Kondoh, Hiroaki Shimizu, Teiji Tominaga

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Recently, temporary balloon test occlusion (BTO) of the internal carotid artery (IC) has become a well accepted procedure for preoperative evaluation of patients with IC large aneurysms. However, it might be dangerous to move patients fitted with a balloon catheter to the room for single-photon emission computed tomography (SPECT). We attempted to clarify the usefulness of regional cerebral oxygen saturation (rSO 2) monitoring during BTO, comparing cerebral blood flow (CBF) obtained from SPECT. Materials and Methods: Eight patients with an IC large aneurysm underwent BTO with rSO 2 monitoring. Regions of interest in the SPECT were denned in the area below the rSO 2 sensor of each hemisphere. Correlations among rSO 2, CBF, stump pressure and appearance of symptoms were discussed. Results: The rSO 2 significantly reduced during BTO (74.1 ± 1.2 to 60.4 ± 2.7%, p<0.001). The individual decreases in rSO 2 correlated with decreases of CBF from SPECT (r=0.966, P<0.001). Four patients with ArSO 2 (baseline rSO 2 - rSO 2 during IC occlusion) less than 12 points had no symptoms, but 4 patients with ArSO 2 more than 14 points had some symptoms. The stump pressure had no correlation with CBF and rSO 2. Conclusions: The rSO 2 significantly correlated with CBF from SPECT and related with appearance of symptoms. Our results revealed that rSO 2 monitoring was useful in BTO, and SPECT could be skipped in some cases to determine the strategies for treatment of IC large aneurysms.

Original languageEnglish
Pages (from-to)605-702
Number of pages98
JournalNeurological Surgery
Volume34
Issue number7
Publication statusPublished - 2006 Jul

Keywords

  • Balloon test occlusion
  • Cerebral blood flow
  • Giant aneurysm
  • Regional cerebral oxygen saturation
  • Single photon emission computed tomography

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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