Cerebral Near-Infrared Spectroscopy: A Potential Approach for Thrombectomy Monitoring

Abstract

Background and purpose: Regional brain oxygen saturation (rSO₂) changes, assessed by cerebral near-infrared spectroscopy, are likely influenced by cerebral hemodynamic fluctuations induced by thrombectomy of acute proximal occlusion. We studied the correlations between rSO₂ and baseline magnetic resonance imaging perfusion parameters and the relationship between rSO₂ changes, recanalization, and clinical outcome.

Methods: Seventeen acute ischemic stroke patients, treated with mechanical thrombectomy, were monitored using bilateral near-infrared spectroscopy before, during, and continuously for 24 hours after the procedure. All patients had baseline brain magnetic resonance imaging with perfusion weighted imaging.

Results: rSO₂ was only correlated with baseline Tmax (ρ=-0.42; P<0.05) and mean transit time (ρ=-0.45; P<0.05) within forehead explored areas. Before thrombectomy, an interhemispheric rSO₂ difference was noted, and this diminished over time when recanalization had occurred (median [interquartile range], -8 [-12 to -5] to 3 [-3 to 7]; P=0.01). rSO₂ changes were not correlated with clinical outcome.

Conclusions: rSO₂ was merely correlated with baseline Tmax and mean transit time magnetic resonance imaging perfusion parameters. Multiple sites recording beyond frontal pole explored areas may provide more relevant correlation with hemodynamic parameters.

Keywords: humans; magnetic resonance imaging; oxygen; spectroscopy, near-infrared; thrombectomy.