Real-time laser speckle contrast imaging for intraoperative neurovascular blood flow assessment: animal experimental study

The use of various blood flow control methods in neurovascular interventions is crucial for reducing postoperative complications. Neurosurgeons worldwide use different methods, such as contact Dopplerography, intraoperative indocyanine videoangiography (ICG) video angiography, fluorescein angiography, flowmetry, intraoperative angiography, and direct angiography. However, there is no noninvasive method that can assess the presence of blood flow in the vessels of the brain without the introduction of fluorescent substances throughout the intervention. The real-time laser-speckle contrast imaging (LSCI) method was studied for its effectiveness in controlling blood flow in standard cerebrovascular surgery cases in rat common carotid arteries, such as proximal occlusion, trapping, reperfusion, anastomosis, and intraoperative vessel thrombosis. The real-time LSCI method is a promising method for use in neurosurgical practice. This approach allows timely diagnosis of intraoperative disturbance of blood flow in vessels in cases of clip occlusion or thrombosis. Additionally, LSCI allows us to reliably confirm the functioning of the anastomosis and reperfusion after removal of the clips and thrombolysis in real time. An unresolved limitation of the method is noise from movements, but this does not reduce the value of the method. Additional research is required to improve the quality of the data obtained.

Laser Speckle Contrast Imaging in Neurosurgery: A Systematic Review

BACKGROUND

Intraoperative study of blood flow in the brain vessels is among the most critical topics of modern neurosurgery. One of the promising methods for intraoperative monitoring of blood flow is laser speckle contrast imaging (LSCI). This systematic review aims to analyze the experience of using intraoperative LSCI in neurosurgical interventions.

METHODS

The literature search was carried out in the PubMed and Web of Science databases using the keywords "Laser-Speckle," "Laser Speckle," "Laser speckle contrast imaging," and "LSCI." We allowed the search to include the following criteria: 1) publication in the English language, 2) full access to the article, 3) information about the method of treatment, and 4) the results presented for at least one patient.

RESULTS

The initial search resulted in the detection of 508 publications, of which 476 were eliminated during the initial assessment of titles and abstracts. Two more articles were excluded due to the lack of data in the English language. Twenty articles were found to be focused on nonhuman studies and therefore were excluded. In three more studies treatment of non-neurosurgical patients was reported. The final analysis included 8 articles with 102 patients overall.

CONCLUSIONS

LSCI is a promising intraoperative method for intraoperative cerebral blood flow assessing. This method offers several advantages over other modalities. The experience of use is limited to a small number of case series. Further investigation of the method and its implementation in clinical practice is needed.

Impairments of cerebral blood flow microcirculation in rats brought on by cardiac cessation and respiratory arrest

The impairments of cerebral blood flow microcirculation brought on by cardiac and respiratory arrest were assessed with multi-modal diagnostic facilities, utilising laser speckle contrast imaging, fluorescence spectroscopy and diffuse reflectance spectroscopy. The results of laser speckle contrast imaging show a notable reduction of cerebral blood flow in small and medium size vessels during a few minutes of respiratory arrest, while the same effect was observed in large sinuses and their branches during the circulatory cessation. Concurrently, the redox ratio assessed with fluorescence spectroscopy indicates progressing hypoxia, NADH accumulation and increase of FAD consumption. The results of diffuse reflectance spectra measurements display a more rapid grow of the perfusion of deoxygenated blood in case of circulatory impairment. In addition, consequent histopathological analysis performed by using new tissue staining procedure developed in-house. It shows notably higher reduction of size of the neurons due to their wrinkling within brain tissues influenced by circulation impair. Whereas, the brain tissues altered with the respiratory arrest demonstrate focal perivascular oedema and mild hypoxic changes of neuronal morphology. Thus, the study suggests that consequences of a cessation of cerebral blood flow become more dramatic and dangerous compare to respiratory arrest.