Fig 3 - available from: Journal of Cardiothoracic Surgery
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Selective internal carotid artery angiography (Left). Moderate stenosis of the left internal carotid artery and total occlusion of the left middle cerebral artery (arrow 1). Slight collateral circulation (arrow 2) from the left internal carotid artery, external carotid artery, and vertebral artery to the middle cerebral artery territory
Source publication
Background:
Severe carotid and intracranial artery stenosis disease (CIAD) is major risk for perioperative stroke in coronary artery bypass grafting. Then, preoperative risk assessment is quite important.
Case presentation:
A 58-years old Japanese woman with bilateral carotid stenosis and bilateral middle cerebral artery occlusion was suffered f...
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Background
Recent data demonstrated the benefit of left atrial appendage (LAA)-amputation in patients with atrial fibrillation (AF). However, the long-term impact of LAA-amputation for patients with new-onset perioperative atrial fibrillation (POAF) is still unknown.
Methods
Patients with no history of AF undergoing coronary artery bypass grafting...
Citations
... This substance increases cerebral blood flow markedly in unaffected vessels, whereas in areas where blood is supplied by stenotic or malformed vessels, the flow either increases slightly or remains unchanged 9 . Most studies devoted to measurements of cerebral blood flow were carried out using diagnostic methods such as Magnetic Resonance Imaging 6,8 , single-photon or positron emission tomography 3,5 , and Transcranial Doppler ultrasonography 10 . As a rule, the goal of this kind of research is to assess the cerebral perfusion of the patient either to determine the further tactics of his treatment, or to refine the prognosis 3 . ...
... Most studies devoted to measurements of cerebral blood flow were carried out using diagnostic methods such as Magnetic Resonance Imaging 6,8 , single-photon or positron emission tomography 3,5 , and Transcranial Doppler ultrasonography 10 . As a rule, the goal of this kind of research is to assess the cerebral perfusion of the patient either to determine the further tactics of his treatment, or to refine the prognosis 3 . However, in the case of surgical revascularization, it is often necessary to assess the functional reserve of cerebral vessels, both to clarify the region of the lesion and to control the adequacy of surgical intervention. ...
Assessment of the cerebral blood-flow-reserve in patients with cerebrovascular diseases is extremely important in terms of making prognosis, determining treatment tactics, and controlling the revascularization outcome in the case of reconstructive interventions on the brain vessels. However, there is no easy-to-use, contactless method for either assessing the functional reserve of the cortical vascular network or intraoperative monitoring of surgical intervention. Our study aims to demonstrate feasibility of green-light imaging photoplethysmography (iPPG) to estimate cerebrovascular functional reserve in animal model of craniosurgical intervention. Custom-made iPPG system was exploited to visualize intracranial vessels in anesthetized Wistar rats (n = 15). Video frames of rat's cortex were recorded concurrently with systemic blood pressure, end-tidal CO 2 , and electrocardiogram. We found that injection of dorzolamide (carbonic-anhydrase inhibitor) significantly increased the blood-pulsations amplitude in all animals by 35 ± 19% (p < 0.001). Such an increase negatively correlated with significant decrease in end-tidal CO 2 by 32 ± 7% (p < 0.001). It is noteworthy that the dorzolamide injection did not lead to significant changes in systemic blood pressure. Concluding, pulsations amplitude is a marker of the vascular tone that can be used to evaluate the functional cerebrovascular reserve. Imaging PPG is a simple and convenient method to assess cerebral blood flow, including during various neurosurgical interventions.
