Intravascular Near-Infrared Spectroscopy: A Possible Tool for Optimizing the Management of Carotid Artery Disease

Horváth, Martin; Hájek, Petr; Štěchovský, Cyril; Honěk, Jakub; Veselka, Josef

doi:10.1055/s-0035-1558644

Cited by 3 publications

(3 citation statements)

References 57 publications

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“…The amount of lipids is quantified as the lipid core burden index (LCBI), which is a unitless measure defined as the fraction of yellow pixels on the chemogram multiplied by 1000. 18 , 23 , 26 , 27 …”

Section: Methodsmentioning

confidence: 99%

Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Horváth

Hájek

Štěchovský

et al. 2020

European Heart Journal Supplements

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Most atherosclerotic plaques (APs) form in typical predilection areas of low endothelial shear stress (ESS). On the contrary, previous data hinted that plaques rupture in their proximal parts where accelerated blood flow causes high ESS. It was postulated that high ESS plays an important role in the latter stages of AP formation and in its destabilization. Here, we used near-infrared spectroscopy (NIRS) to analyse the distribution of lipid core based on the presumed exposure to ESS. A total of 117 carotid arteries were evaluated using NIRS and intravascular ultrasound (IVUS) prior to carotid artery stenting. The point of minimal luminal area (MLA) was determined using IVUS. A stepwise analysis of the presence of lipid core was then performed using NIRS. The lipid core presence was quantified as the lipid core burden index (LCBI) within 2 mm wide segments both proximally and distally to the MLA. The analysed vessel was then divided into three 20 mm long thirds (proximal, middle, and distal) for further analysis. The maximal value of LCBI (231.9 ± 245.7) was noted in the segment localized just 2 mm proximally to MLA. The mean LCBI in the middle third was significantly higher than both the proximal (121.4 ± 185.6 vs. 47.0 ± 96.5, P < 0.01) and distal regions (121.4 ± 185.6 vs. 32.4 ± 89.6, P < 0.01). Lipid core was more common in the proximal region when compared with the distal region (mean LCBI 47.0 ± 96.5 vs. 32.4 ± 89.6, P < 0.01).

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Section: Methodsmentioning

confidence: 99%

Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Horváth

Hájek

Štěchovský

et al. 2020

European Heart Journal Supplements

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“…The release of these elements into the blood stream which results in distal embolization is a known culprit in peri-procedural myonecrosis ( 35 , 38 , 49 – 51 ). Similarly, the utility of NIRS-IVUS in optimizing carotid artery stenting toward preventing periprocedural stroke is a subject of ongoing research ( 52 , 53 ).…”

Section: Applications Of Nirs-ivusmentioning

confidence: 99%

“…The release of these elements into the blood stream which results in distal embolization is a known culprit in peri-procedural myonecrosis (35,38,(49)(50)(51). Similarly, the utility of NIRS-IVUS in optimizing carotid artery stenting toward preventing periprocedural stroke is a subject of ongoing research (52,53). Furthermore, NIRS-IVUS has been employed in the study of plaque morphology and composition in the peripheral arteriessuperficial femoral arteries in the setting of severe stenoses and symptomatic peripheral artery disease (PAD) (54,55).…”

Section: Clinical Applications Of Intracoronary Near-infrared Spectroscopymentioning

confidence: 99%

Near-Infrared Spectroscopy Intravascular Ultrasound Imaging: State of the Art

Kuku

Singh

Ozaki

et al. 2020

Front. Cardiovasc. Med.

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Acute coronary syndromes (ACS) secondary to coronary vessel plaques represent a major cause of cardiovascular morbidity and mortality worldwide. Advancements in imaging technology over the last 3 decades have continuously enabled the study of coronary plaques via invasive imaging methods like intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The introduction of near-infrared spectroscopy (NIRS) as a modality that could detect the lipid (cholesterol) content of atherosclerotic plaques in the early nineties, opened the potential of studying “vulnerable” or rupture-prone, lipid-rich coronary plaques in ACS patients. Most recently, the ability of NIRS-IVUS to identify patients at risk of future adverse events was shown in a prospective multicenter trial, the Lipid-Rich-plaque Study. Intracoronary NIRS-IVUS imaging offers a unique method of coronary lipid-plaque characterization and could become a valuable clinical diagnostic and treatment monitoring tool.

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Near Infrared Spectroscopy For Cerebral Hemodynamic Monitoring During Carotid Endarterectomy Under General Anesthesia

Rein¹,

Siqueira²,

Guillaumon³

et al. 2022

TOCMJ

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Background: Near infrared spectroscopy (NIRS) is a noninvasive method for continuous monitoring of cerebral oxygenation. Objective: To describe the intraoperative behavior of NIRS variables used to evaluate hemodynamic response in patients with atherosclerotic disease undergoing carotid endarterectomy under general anesthesia. Methods: Fifteen volunteers with atherosclerotic carotid disease with indications for endarterectomy were evaluated. After selection of patients, carotid stenosis was confirmed by appropriate diagnostic methods. NIRS was used for intraoperative monitoring. The variables total hemoglobin (Hb), oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), and regional oxygen saturation (rSO2) were evaluated at three intraoperative time points: before, during, and after carotid clamping. Results and Discussion: Measurements recorded by NIRS showed that, during the first 5 min of clamp time, patients experienced a decline in O2Hb levels, an increase in HHb levels, and a marked decrease in rSO2. Hb remained constant throughout the procedure. At the post-clamping time point, HHb, O2Hb, and rSO2 returned to patterns similar to those observed before clamping. Conclusion: NIRS was able to reliably and accurately identify the three stages of carotid endarterectomy and may predict the risk of cerebral hypoxia during carotid clamping under general anesthesia.

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Intravascular Near-Infrared Spectroscopy: A Possible Tool for Optimizing the Management of Carotid Artery Disease

Cited by 3 publications

References 57 publications

Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Carotid artery plaque composition and distribution: near-infrared spectroscopy and intravascular ultrasound analysis

Near-Infrared Spectroscopy Intravascular Ultrasound Imaging: State of the Art

Near Infrared Spectroscopy For Cerebral Hemodynamic Monitoring During Carotid Endarterectomy Under General Anesthesia

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