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Mapping the collateral network: Optimal near-infrared spectroscopy optode placement.

Konstantin von Aspern1, Josephina Haunschild1, Zara Khachatryan1

  • 1University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany; Saxonian Incubator for Clinical Translation, University of Leipzig, Leipzig, Germany.

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Summary

This study found that collateral network (CN) near-infrared spectroscopy (cnNIRS) effectively monitors spinal cord oxygenation during aortic procedures. Optimal placement for cnNIRS is from the mid-thoracic to the lower lumbar region.

Keywords:
cnNIRScollateral networkischemic spinal cord injurylarge animal modelnear-infrared spectroscopynoninvasive monitoringthoracoabdominal aorta

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Area of Science:

  • Cardiovascular Surgery
  • Neuroscience
  • Biomedical Engineering

Background:

  • Paraplegia is a severe complication of extensive aortic procedures.
  • Maintaining spinal cord perfusion and oxygenation is crucial for preventing paraplegia.
  • Collateral network (CN) near-infrared spectroscopy (cnNIRS) offers noninvasive monitoring of spinal cord oxygenation.

Purpose of the Study:

  • To identify optimal cnNIRS positioning for routine clinical use.
  • To investigate the entire paraspinous CN using cnNIRS.
  • To assess cnNIRS's ability to detect changes during aortic ischemia and reperfusion.

Main Methods:

  • Paraspinous CN was measured using cnNIRS from T4 to L5 in juvenile pigs during aortic ischemia and reperfusion.
  • cnNIRS data were compared with direct regional tissue perfusion of the CN and spinal cord.
  • Measurements were taken in an acute large animal model.

Main Results:

  • cnNIRS decreased significantly from the mid-thoracic to the low lumbar level during ischemia, with more pronounced caudal changes.
  • High thoracic cnNIRS remained stable.
  • cnNIRS measurements showed comparable progression to direct CN and spinal cord perfusion data.

Conclusions:

  • cnNIRS can detect relevant ischemia/reperfusion changes from the mid-thoracic level downwards.
  • Optimal cnNIRS placement for extensive aortic procedures is T7-T9 to L3-L5.
  • cnNIRS is a versatile monitoring method for various aortic procedures.