Padhy Sashmita Kumari, Ajayan Neeraja, Hrishi Ajay Prasad, Thakkar Keta Deepak, Sethuraman Manikandan
Division of Neuroanaesthesia, Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Brain Circ. 2019 Apr-Jun;5(2):90-93. doi: 10.4103/bc.bc_12_19. Epub 2019 Jun 27.
One of the complications of carotid artery stenting (CAS) is iatrogenic vasospasm caused by mechanical irritation of the blood vessel lumen by a guidewire, catheter, stent retriever, or distal protection devices. Although often self-limiting, the mechanical vasospasm can cause reduction in the cerebral blood flow and result in catastrophic ischemia, especially when undetected and persistent. Real-time cerebral oximetry with near-infrared spectroscopy (NIRS) could detect episodes of cerebral hypoxemia due to vasospasm and facilitate intervention for prevention of hypoxic brain injury during neuro-intervention procedures such as CAS. We present a case scenario where NIRS detected iatrogenic vasospasm even before the conventional tests could identify the event during CAS.
颈动脉支架置入术（CAS）的并发症之一是医源性血管痉挛，它由导丝、导管、支架回收器或远端保护装置对血管腔的机械刺激引起。尽管这种机械性血管痉挛通常具有自限性，但它可导致脑血流量减少并引发灾难性缺血，尤其是在未被发现且持续存在的情况下。采用近红外光谱技术（NIRS）的实时脑血氧饱和度监测能够检测出因血管痉挛导致的脑缺氧发作，并有助于在诸如CAS等神经介入手术过程中进行干预，以预防缺氧性脑损伤。我们呈现了一个病例，在该病例中，即使传统检查在CAS期间尚未识别出医源性血管痉挛事件，NIRS也检测到了它。
