Transluminal Balloon Angioplasty Improves Brain Tissue Oxygenation and Metabolism in Severe Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Case Report

Hoelper, B. M.; Hofmann, Erich; Sporleder, Roland; Soldner, F.; Behr, Robert

doi:10.1227/01.neu.0000053033.98317.a3

Cited by 36 publications

(12 citation statements)

References 40 publications

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“…Systemic circulation was not affected from intraarterial nimodipine, as seen on arterial pressure and continuous cardiac output monitoring Experience with brain tissue oxygenation in vasospasm was mostly acquired in the evaluation of standard hypervolemic therapy [16,17]. Regarding endovascular vasospasm therapy, increase [18] as well as decrease [19] of brain tissue oxygenation is described. In the latter study, intraarterial papaverine was used for vasodilation.…”

Section: Discussionmentioning

confidence: 99%

Continuous Selective Intraarterial Infusion of Nimodipine for Therapy of Refractory Cerebral Vasospasm

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Continuous Selective Intraarterial Infusion of Nimodipine for Therapy of Refractory Cerebral Vasospasm

et al. 2009

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“…Furthermore, it is described to survey cerebral oxygenation for treating increased intracranial pressure [11,18,21,24,26,27]. The risk for cerebral ischemia due to reduced cerebral blood flow can also be monitored by this method following subarachnoid haemorrhage [2,5,7,9,10,17] and stroke [6,19]. Two currently available systems are based on different technologies: an electrochemical pO 2 -sensor (Licox, LX) and a fluorescent pO 2 -sensor (Neurotrend, NT).…”

Section: Introductionmentioning

confidence: 99%

Brain oxygen monitoring: in-vitro accuracy, long-term drift and response-time of Licox- and Neurotrend sensors

Hoelper

Alessandri

Heimann

et al. 2005

Acta Neurochir (Wien)

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SummaryBackground. Oxygen tension sensors have been used to monitor tissue oxygenation in human brain for several years. The working principals of the most frequently used sensors, the Licox (LX) and Neurotrend (NT), are different, and they have never been validated independently for correct measurement in vitro. Therefore, we tried to clarify if the two currently available sensors provide sufficient accuracy and stability.Method. 12 LX oxygen tension sensors and NT sensors were placed into a liquid-filled tonometer chamber. The solution was kept at 37 AE 0.2 C and equilibrated with five calibration gases containing different O 2 -and CO 2 -concentrations. After equilibration, readings were taken for each gas concentration (accuracy test). Afterwards, the sensors were left in 3% O 2 and 9% CO 2 and readings were taken after 24, 48, 72, 96 and 120 hours (drift test). Thereafter, a 90% response time test was performed transferring sensors from 1% to 5% oxygen concentration and back, using pre-equilibrated tonometers.Findings. All Licox oxygen probes [12] were used for this study. Two of 14 Neurotrend sensors did not calibrate, revealing a failure rate of 14% for NT. Oxygen tension during the accuracy test was measured as follows: 1% O 2 (7.1 mmHg): LX 6.5 AE 0.4, NT 5.3 AE 2.3 mmHg, 2% O 2 (14.2 mmHg): LX 12.9 AE 0.6, NT 12.1 AE 2.2 mmHg, 3% O 2 (21.4 mmHg): LX 19.8 AE 0.7, NT 19.4 AE 2.4 mmHg, 5% O 2 (35.8 mmHg): LX 33.4 AE 1.0 mmHg, NT 33.5 AE 2.9 mmHg, 8% O 2 (57.0 mmHg): 53.8 AE 1.5, NT 53.6 AE 3.3 mmHg. After 120 hours in 3% O 2 (21 mmHg), LX measured 19.8 AE 1.9 mmHg, NT 17.9 AE 4.7 mmHg. 90% response time from 1% to 5%=5% to 1% oxygen concentration was 129 AE 27=174 AE 26 sec for LX, 55 AE 19=98 AE 39 sec for NT.Conclusions. Both systems are measuring oxygen tension sufficiently, but more accurately with LX probes. NT sensors read significantly lower pO 2 in 1% O 2 and show an increasing deviation with higher oxygen concentrations which was due to two of twelve probes. A slight drift towards lower oxygen tension readings for both sensors but more pronounced for the NT does not impair long-term use. NT measures pCO 2 and pH very accurately.

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“…A promising strategy that is already being used in many neurotrauma centers for TBI management is continuous brain tissue oxygen (P bt O 2 ) monitoring. P bt O 2 probes have been successfully used in screening patients with aneurysmal subarachnoid hemorrhage [59,60], and have proven effective in demonstrating the therapeutic effects of induced hypertension [61] and balloon angioplasty [62]. LicoxÒ probes (Integra NeuroSciences, Plainsboro, NJ) are simple to use, highly accurate, and have become increasingly popular in modern-day neurocritical care units [63].…”

Section: Screening For Ptvmentioning

confidence: 99%

Posttraumatic Vasospasm Detected by Continuous Brain Tissue Oxygen Monitoring: Treatment with Intraarterial Verapamil and Balloon Angioplasty

et al. 2008

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Transluminal Balloon Angioplasty Improves Brain Tissue Oxygenation and Metabolism in Severe Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Case Report

Cited by 36 publications

References 40 publications

Continuous Selective Intraarterial Infusion of Nimodipine for Therapy of Refractory Cerebral Vasospasm

Continuous Selective Intraarterial Infusion of Nimodipine for Therapy of Refractory Cerebral Vasospasm

Brain oxygen monitoring: in-vitro accuracy, long-term drift and response-time of Licox- and Neurotrend sensors

Posttraumatic Vasospasm Detected by Continuous Brain Tissue Oxygen Monitoring: Treatment with Intraarterial Verapamil and Balloon Angioplasty

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