24-Hour Near-Infrared Spectroscopy Monitoring of Acute Ischaemic Stroke Patients Undergoing Thrombolysis or Thrombectomy: A Pilot Study

J Stroke Cerebrovasc Dis. 2019 Aug;28(8):2337-2342. doi: 10.1016/j.jstrokecerebrovasdis.2019.05.026. Epub 2019 Jun 8.

Abstract

Introduction: Monitoring of acute ischaemic stroke patients during thrombolysis or thrombectomy is based mostly on frequent physical examinations, since no objective measurement of cerebrovascular haemodynamics is available in routine clinical practice. Near-infrared spectroscopy (NIRS) is a bed-side, noninvasive assessment tool that could help monitor these patients and potentially guide therapeutic interventions. Our goal in this pilot study was to investigate whether NIRS is a suitable method to monitor leptomeningeal collateral circulation via changes in cortical oxygen saturation in the first 24 hours of acute ischaemic stroke.

Patients and methods: Our study included 5 patients with acute anterior circulation infarcts. All patients received thrombolytic therapy and 1 had thrombectomy. 24-hour continuous NIRS monitoring was performed on all participants.

Results: We aimed to give a detailed description of each NIRS recording and explain how the observed findings could correlate with changes in anterior watershed territory collateral circulation and clinical outcome.

Conclusion: Our pilot study supports the use of NIRS monitoring in acute ischaemic stroke. We believe that this technique could provide real-time information on the dynamic changes of leptomeningeal collateral circulation and help monitor the effects of thrombolysis and thrombectomy.

Keywords: Near-infrared spectroscopy (NIRS); collateral circulation; ischaemic stroke; thrombolysis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Infarction / blood
  • Brain Infarction / diagnosis*
  • Brain Infarction / physiopathology
  • Brain Infarction / therapy*
  • Cerebrovascular Circulation
  • Collateral Circulation
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Ambulatory / methods*
  • Pilot Projects
  • Point-of-Care Systems*
  • Point-of-Care Testing*
  • Predictive Value of Tests
  • Spectroscopy, Near-Infrared*
  • Thrombectomy* / adverse effects
  • Thrombolytic Therapy / adverse effects
  • Thrombolytic Therapy / methods*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Fibrinolytic Agents