722 CHARACTERIZATION OF RENAL ISCHEMIA USING DLP® HYPERSPECTRAL IMAGING: A COMPARISON OF ARTERY-ONLY OCCLUSION (AO) VERSUS ARTERY AND VEIN OCCLUSION (AV)

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy/Ureteroscopy I1 Apr 2010722 CHARACTERIZATION OF RENAL ISCHEMIA USING DLP® HYPERSPECTRAL IMAGING: A COMPARISON OF ARTERY-ONLY OCCLUSION (AO) VERSUS ARTERY AND VEIN OCCLUSION (AV) Chad R. Tracy, John D. Terrell, Robert P. Francis, Eleanor F. Wehner, Jack Smith, Maritoni Litorja, Doyle L. Hawkins, Jeffrey A. Cadeddu, and Karel J. Zuzak Chad R. TracyChad R. Tracy Iowa City, IA More articles by this author , John D. TerrellJohn D. Terrell Dallas, TX More articles by this author , Robert P. FrancisRobert P. Francis Arlington, TX More articles by this author , Eleanor F. WehnerEleanor F. Wehner Arlington, TX More articles by this author , Jack SmithJack Smith Dallas, TX More articles by this author , Maritoni LitorjaMaritoni Litorja Gaithersburg, MD More articles by this author , Doyle L. HawkinsDoyle L. Hawkins Arlington, TX More articles by this author , Jeffrey A. CadedduJeffrey A. Cadeddu Dallas, TX More articles by this author , and Karel J. ZuzakKarel J. Zuzak Arlington, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1210AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal artery-only occlusion (AO), as opposed to artery and vein occlusion (AV), may have some benefit in reducing renal insufficiency during warm ischemia. We utilized DLP® hyperspectral imaging (HSI) to construct a “real time” tissue oxygenation “map” in order to determine whether there are differences in renal tissue oxygenation during vascular occlusion with AO versus AV. METHODS Renal vascular occlusion with either AO or AV was performed for 60 minutes in 7 porcine renal units. Using HSI, the percentage of oxyhemoglobin in the renal cortex was determined at 4-minute increments throughout the ischemic period and for 30 minutes following reperfusion. RESULTS Average baseline percentage of oxyhemoglobin (% HbO2) in all animals was approximately 70%. Following vascular occlusion in both cohorts, % HbO2 decreased by 1/3 within 2-5 minutes, with a gradual decline in % HbO2 over the remaining 55 minutes. Oxyhemoglobin profiles for AO and AV occlusion diverged significantly between 16 and 24 minutes following vascular occlusion (p=0.0001 and 0.036, respectively), with a merging of the two curves occurring after approximately 36 minutes (p=0.093). During reperfusion, average % HbO2 improved to 72.4% after 25-30 minutes. CONCLUSIONS Renal tissue oxygenation drops rapidly following occlusion of the renal vasculature and returns to near baseline 30 minutes following reperfusion. In the porcine model, the percentage of oxyhemoglobin differs significantly between AO and AV occlusion for up to 35 minutes following ischemia onset, indicating a possible “ischemic window” where AO occlusion may provide benefit over AV occlusion. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e281 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chad R. Tracy Iowa City, IA More articles by this author John D. Terrell Dallas, TX More articles by this author Robert P. Francis Arlington, TX More articles by this author Eleanor F. Wehner Arlington, TX More articles by this author Jack Smith Dallas, TX More articles by this author Maritoni Litorja Gaithersburg, MD More articles by this author Doyle L. Hawkins Arlington, TX More articles by this author Jeffrey A. Cadeddu Dallas, TX More articles by this author Karel J. Zuzak Arlington, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...