Ocular blood flow measured by laser speckle flowgraphy during aortic arch surgery

• Project/Area Number: 18K08825
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Nara Medical University
• Principal Investigator: Hayashi Hironobu 奈良県立医科大学, 医学部, 講師 (30464663)
• Co-Investigator(Kenkyū-buntansha): 松浦 豊明 奈良県立医科大学, 医学部, 非常勤講師 (10238959) ; 岡本 全弘 奈良県立医科大学, 医学部附属病院, 研究員 (30458038) ; 吉谷 健司 国立研究開発法人国立循環器病研究センター, 病院, 部長 (30524029) ; 井上 聡己 奈良県立医科大学, 医学部, 病院教授 (50295789) ; 緒方 奈保子 奈良県立医科大学, 医学部, 教授 (60204062) ; 川口 昌彦 奈良県立医科大学, 医学部, 教授 (60275328) ; 谷口 繁樹 奈良県立医科大学, 医学部, 教授 (90183467)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000); Fiscal Year 2021: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: レーザースペックルフローグラフィ / 眼血流 / 脳血流 / 脳合併症 / 心臓血管手術 / モニタリング / 内頸動脈内膜剥離術 / 術後中枢神経障害 / 脳循環 / 胸部大動脈人工血管置換術 / 術中モニタリング / 術後脳障害 / 心臓血管外科手術 / 人工心肺 / 脳分離体外循環 / LSFG / 大血管手術 / 頸動脈遮断 / レーザースペックルフローグラフィー

Outline of Final Research Achievements

We reported the usefulness of ocular blood flow monitoring by laser speckle flowography (LSFG) as an indicator of cerebral perfusion during cardiovascular surgery. We also investigated the association between the rate of ocular blood flow reduction and the risk of cerebral injury occurrence. We investigated the association between changes in ocular blood flow by LSFG and changes in motor evoked potentials during carotid endarterectomy carotid artery occlusion. In the group that showed a significant decrease in motor evoked potentials (n=5), the LSFG-induced decrease in ocular blood flow was 23±14%, and in the group that did not show a significant decrease (n=10), the decrease was 80±32%. These results suggest that a warning line for LSFG-induced reduction in ocular blood flow of 30% or less compared to baseline is appropriate.

Academic Significance and Societal Importance of the Research Achievements

心臓血管手術や頸動脈手術などでは術後脳合併症が問題になる。これらの手術では術中に脳モニタリングを行うことが術後脳合併症を回避することに寄与できる。レーザースペックルフローグラフィによる眼血流モニタリングは、術後脳合併症リスクの高い手術で、脳保護戦略の一つとして使用できることが示唆された。

Research Products

• [Journal Article] Ocular blood flow by laser speckle flowgraphy to detect cerebral ischemia during carotid endarterectomy. (2020)
  • Author(s): Yasushi Motoyama, Hironobu Hayashi
  • Journal Title: J Clin Monit Comput. Volume: Undetermined Issue: 2 Pages: 327-336
  • DOI: 10.1007/s10877-020-00475-1
  • Peer Reviewed
• [Presentation] 頚動脈内膜剥離術の術中と術後に脳モニターとしてLaser speckle flowgraphyを用いた2症例 (2022)
  • Author(s): 大井彩子、林浩伸、小川裕貴、植村景子、高谷恒範、川口昌彦
  • Organizer: 日本神経麻酔集中治療学会
• [Presentation] Application of ocular blood flow measured by laser speckle flowgraphy for assessment of cerebral perfusion during carotid endarterectomy (2019)
  • Author(s): Hironobu Hayashi, Hideaki Kawanishi, Masahiko Kawaguchi
  • Organizer: ICCV 2019
  • Int'l Joint Research
• [Presentation] Application of ocular blood flow measured by laser speckle flowgraphy for assessment of cerebral perfusion during carotid endarterectomy (2019)
  • Author(s): Hironobu Hayashi
  • Organizer: International congress of cardiothoracic and vascular anesthesia
  • Int'l Joint Research
• [Presentation] 頸動脈内膜剥離術におけるレーザースペックルフローグラフィの応用 (2018)
  • Author(s): 林 浩伸
  • Organizer: レーザースペックル研究会
  • Invited