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  • 27 - Near infrared spectroscopy in carotid endarterectomy

  • from Monitoring the local and distal effects of carotid interventions
  • Edited by Jonathan Gillard, University of Cambridge, Martin Graves, University of Cambridge, Thomas Hatsukami, University of Washington, Chun Yuan, University of Washington
  • Book:
    Carotid Disease
    Published online:
    03 December 2009
    Print publication:
    07 December 2006, pp 372-386

  • Summary

    The use of near infrared spectroscopy (NIRS) to evaluate cerebral oxygenation changes has been reported in a variety of medical and neurosurgical conditions. This chapter looks at the application of NIRS during carotid endarterectomy. It demonstrates our own use of this technique in combination with other monitoring modalities. The NIRO 300 is a noninvasive bedside monitor which gives simultaneous measurement of tissue oxygen index (TOI) and hemoglobin concentration changes. The instrument is based on technology employed in the earlier NIRO 500 and a prototype spatially resolved spectrometer. The reliable detection of compromised regional cerebral perfusion therefore plays an important role in the management of patients undergoing carotid surgery. During carotid endarterectomy, segregation of the NIRS signal between intra- and extracranial vascular territories is possible, by staged application of vascular clamps to the external and internal carotid arteries.