{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:14:00Z","timestamp":1780485240096,"version":"3.54.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1997,5]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            The internal carotid (ICA) and external carotid (ECA) contributions to changing concentrations of oxyhemoglobin (Hb\n            <jats:sc>o<\/jats:sc>\n            <jats:sub>2<\/jats:sub>\n            ) and deoxyhemoglobin (Hb) during carotid endarterectomy were assessed with the use of near-infrared spectroscopy (NIRS).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            NIRS optodes were placed on the forehead with an interoptode distance of 6 cm, and laser-Doppler flowmetry (LDF) was used to monitor the change in skin blood flow between the optodes. Hb, Hb\n            <jats:sc>o<\/jats:sc>\n            <jats:sub>2<\/jats:sub>\n            , LDF, arterial blood pressure, and middle cerebral artery flow velocity were recorded continuously. The ECA was clamped 2 minutes before the ICA was clamped. Suitable multimodal recordings were achieved in 44 patients.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            When the ECA was clamped, 76% of patients showed a fall in Hb\n            <jats:sc>o<\/jats:sc>\n            <jats:sub>2<\/jats:sub>\n            and 65% an increase in Hb. When corrected for changes in arterial blood pressure, an accompanying fall in cutaneous LDF predicted the fall in Hb\n            <jats:sc>o<\/jats:sc>\n            <jats:sub>2<\/jats:sub>\n            with high sensitivity (100%) and specificity (100%). Among those with no NIRS changes during ECA clamping, 56% had severe ECA stenosis or occlusion; none of these showed an accompanying fall in LDF. In contrast, when the ICA was clamped, substantial additional changes in NIRS occurred in 55% of cases, all of which were associated with a fall in flow velocity, but none with a change in LDF. Patients with a constant flow velocity after ICA clamping also showed no change in NIRS.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            Both the ECA and ICA vascular territories contribute to NIRS changes during carotid endarterectomy. The external carotid contribution to NIRS can be monitored with cutaneous LDF.\n          <\/jats:p>","DOI":"10.1161\/01.str.28.5.906","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"906-911","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Internal and External Carotid Contributions to Near-Infrared Spectroscopy During Carotid Endarterectomy"],"prefix":"10.1161","volume":"28","author":[{"given":"Joseph M.K.","family":"Lam","sequence":"first","affiliation":[{"name":"From the Medical Research Council Cambridge Center for Brain Repair and Academic Neurosurgical Unit, and Department of Radiology (P.G.), Addenbrooke\u2019s Hospital, Cambridge, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Smielewski","sequence":"additional","affiliation":[{"name":"From the Medical Research Council Cambridge Center for Brain Repair and Academic Neurosurgical Unit, and Department of Radiology (P.G.), Addenbrooke\u2019s Hospital, Cambridge, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pippa","family":"Al-Rawi","sequence":"additional","affiliation":[{"name":"From the Medical Research Council Cambridge Center for Brain Repair and Academic Neurosurgical Unit, and Department of Radiology (P.G.), Addenbrooke\u2019s Hospital, Cambridge, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Griffiths","sequence":"additional","affiliation":[{"name":"From the Medical Research Council Cambridge Center for Brain Repair and Academic Neurosurgical Unit, and Department of Radiology (P.G.), Addenbrooke\u2019s Hospital, Cambridge, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Pickard","sequence":"additional","affiliation":[{"name":"From the Medical Research Council Cambridge Center for Brain Repair and Academic Neurosurgical Unit, and Department of Radiology (P.G.), Addenbrooke\u2019s Hospital, Cambridge, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Kirkpatrick","sequence":"additional","affiliation":[{"name":"From the Medical Research Council Cambridge Center for Brain Repair and Academic Neurosurgical Unit, and Department of Radiology (P.G.), Addenbrooke\u2019s Hospital, Cambridge, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4615-3428-0_25"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3940(93)90094-2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.929199"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199005000-00006"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.bmb.a072289"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4615-3404-4_17"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/40\/2\/007"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1990.69.3.907"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4684-5188-7_28"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02523341"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.82.5.0756"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.1993.66"},{"key":"e_1_3_2_13_2","first-page":"99","volume":"61","year":"1990","unstructured":"Glaister DH, Miller NL. 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