Cerebral oximetry during carotid artery clamping

NIRS provides a means to assess cerebral oxygenation (and, by inference, cerebral blood flow) during operations involving the aortic arch. A decrease in the rSO₂ was noted in the ipsilateral frontal cortex (the left cortex) during temporary clamping of the LCCA and the innominate artery during a hybrid arch debranching procedure for repair of an aortic arch aneurysm. The image shows an initial decrease in rSO₂ over the left cortex following LCCA clamping and recovery after blood flow to the LCCA was restored (LCCA graft opened). Minutes later, a decrease in rSO₂ over the right cerebral cortex was recorded when the innominate artery was temporarily occluded; this was also followed by a recovery in rSO₂ after blood flow to the innominate artery was restored (Innom A graft opened). Continuous EEG monitoring during the procedure (not shown) was used to verify that the temporary reductions in rSO₂ were not associated with cerebral ischemia.

LCCA: left common carotid artery; Innom A: innominate artery; L: left; R: right; NIRS: near-infrared spectroscopy; rSO₂: regional cerebral oxygen saturation; EEG: electroencephalogram.

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Cerebral oximetry during carotid artery clamping