Department of Anesthesiology, Columbia University, New York, NY, USA.
J Neurosurg Anesthesiol. 2011 Jul;23(3):247-50. doi: 10.1097/ANA.0b013e318210419a.
Stroke remains a significant risk of carotid revascularization for atherosclerotic disease. Emboli generated at the time of treatment either using endarterectomy or stent-angioplasty may progress with blood flow and lodge in brain arteries. Recently, the use of protection devices to trap emboli created at the time of revascularization has helped to establish a role for stent-supported angioplasty compared with endarterectomy. Several devices have been developed to reduce or detect emboli that may be dislodged during carotid artery stenting to treat carotid artery stenosis. A significant challenge in assessing the efficacy of these devices is precisely determining when emboli are dislodged in real time. To address this challenge, we devised a method of simultaneously recording fluoroscopic images, transcranial Doppler data, vital signs, and digital video of the patient/physician. This method permits accurate causative analysis and allows procedural events to be precisely correlated to embolic events in real time.
中风仍然是动脉粥样硬化性疾病颈动脉血运重建的一个重大风险。在治疗过程中产生的栓子,无论是采用内膜切除术还是支架血管成形术,都可能随血流前进并在脑动脉中停留。最近,使用保护装置来捕获在血运重建过程中产生的栓子,有助于确定支架支持的血管成形术与内膜切除术相比的作用。已经开发了几种装置来减少或检测在治疗颈动脉狭窄的颈动脉支架置入术过程中可能脱落的栓塞物。评估这些装置疗效的一个重大挑战是准确确定栓塞物何时实时脱落。为了解决这一挑战,我们设计了一种同时记录荧光透视图像、经颅多普勒数据、生命体征和患者/医生数字视频的方法。这种方法允许进行准确的因果分析,并允许实时将程序事件与栓塞事件精确相关联。