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Journal of Clinical Monitoring and Computing

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01-04-2021 | Motor Evoked Potential | Original Research

Ocular blood flow by laser speckle flowgraphy to detect cerebral ischemia during carotid endarterectomy

Authors: Yasushi Motoyama, Hironobu Hayashi, Hideaki Kawanishi, Kohsuke Tsubaki, Tsunenori Takatani, Yoshiaki Takamura, Masashi Kotsugi, Taekyun Kim, Shuichi Yamada, Ichiro Nakagawa, Young-Su Park, Masahiko Kawaguchi, Hiroyuki Nakase

Published in: Journal of Clinical Monitoring and Computing | Issue 2/2021

Abstract

Laser speckle flowgraphy (LSFG) is a noninvasive technique that can measure relative blood flow velocity in the optic fundus contributed by the ophthalmic artery, the main first branch originating from the internal carotid artery (ICA). The aim of this study was to assess the feasibility of ocular blood flow measurement by LSFG to detect ischemic stress due to carotid clamping during carotid endarterectomy (CEA). Nineteen patients undergoing CEA with ocular blood flow measurement by LSFG and intraoperative monitoring (IOM) were prospectively enrolled between August 2016 and March 2019. The mean blur rate (MBR) of ocular blood flow by LSFG, representing relative blood flow of the branch of the retinal artery originating from the optic nerve head, was compared between before and after carotid clamping during CEA. The correlation between the reduction ratio of MBR and the regional saturation oxygen (rSO₂) index by near infrared spectroscopy was investigated. Ocular blood flow measurement by LSFG could not be performed in one patient with a severe cataract. In the other 18 patients, LSFG could be performed in all 106 sessions during surgery. The MBR reduction ratio between before and after carotid clamping ranged from − 12 to 100%. The MBR reduction ratio was positively correlated with the rSO₂ index (r = 0.694, 95% confidence interval: 0.336–0.877, p = 0.001). The MBR reduction ratio of ocular blood flow by LSFG after carotid clamping was significantly correlated with the rSO₂ index. The ocular blood flow by LSFG could be considered an adjunct modality for evaluating cerebral ischemic tolerance during CEA.

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Title: Ocular blood flow by laser speckle flowgraphy to detect cerebral ischemia during carotid endarterectomy
Authors: Yasushi Motoyama
Hironobu Hayashi
Hideaki Kawanishi
Kohsuke Tsubaki
Tsunenori Takatani
Yoshiaki Takamura
Masashi Kotsugi
Taekyun Kim
Shuichi Yamada
Ichiro Nakagawa
Young-Su Park
Masahiko Kawaguchi
Hiroyuki Nakase
Publication date: 01-04-2021
Publisher: Springer Netherlands
Keywords: Motor Evoked Potential
Somatosensory Evoked Potential
Carotid Endarterectomy
Motor Evoked Potential
Somatosensory Evoked Potential
Laser
Published in: Journal of Clinical Monitoring and Computing / Issue 2/2021
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-020-00475-1

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Ocular blood flow by laser speckle flowgraphy to detect cerebral ischemia during carotid endarterectomy

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