First prize: Characterization of renal ischemia using dlp® hyperspectral imaging: A pilot study comparing artery-only occlusion versus artery and vein occlusion

Chad R. Tracy, John D. Terrell, Robert P. Francis, Eleanor F. Wehner, Jack Smith, Maritoni Litorja, Doyle L. Hawkins, Margaret S Pearle, Jeffrey A Cadeddu, Karel J. Zuzak

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Background and Purpose: Renal artery-only (AO) occlusion, as opposed to artery and vein (AV) occlusion, has demonstrated some benefit in reducing renal insufficiency during warm ischemia. In this pilot study, we used digital light projection hyperspectral imaging (HSI) to construct a "real time" tissue oxygenation "map" to determine whether there are differences in renal tissue oxygenation during vascular occlusion with AO vs AV. Materials and Methods: Renal vascular occlusion with either AO or AV was performed for 60 minutes in seven porcine renal units. Using HSI, the percentage of oxyhemoglobin (%HbO2) in the renal cortex was determined at 4-minute increments throughout the ischemic period and for 30 minutes after reperfusion. Results: Average baseline %HbO2 in all animals was approximately 70%. After vascular occlusion in both cohorts, %HbO2 decreased by one third within 2 to 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 after 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 to 30 minutes. Conclusion: In this pilot study, we demonstrate that renal tissue oxygenation drops rapidly after occlusion of the renal vasculature and returns to near baseline 30 minutes after reperfusion. In the porcine model, the %HbO2 differs significantly between AO and AV occlusion for up to 35 minutes after ischemia onset, indicating a possible "ischemic window" in which AO occlusion may provide benefit over AV occlusion.

Original languageEnglish (US)
Pages (from-to)321-325
Number of pages5
JournalJournal of Endourology
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2010

ASJC Scopus subject areas

  • Urology

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