The purpose of this study is to further elaborate the role of both arterial blood pressure and end-tidal carbon dioxide concentration on measured venous pressures.
To prospectively evaluate the effect of changes in end-tidal carbon dioxide and arterial blood pressure on venous sinus pressure measurements in patients undergoing venous sinus stenting under general anesthesia. Venous sinus pressure measurements will increase with increases in both arterial blood pressure and end-tidal carbon dioxide concentrations.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
8
Venous sinus stenting is performed under general anesthesia. Patients are loaded with aspirin and clopidogrel before the procedure. After induction, the right femoral vein is accessed and an 8 F sheath is placed. Intravenous heparin is administered. A 0.070-0.088 guide catheter is navigated into the ipsilateral jugular vein near the jugular bulb. Pre-stenting manometry is performed in every patient. To do so, a Renegade Hi-Flo microcatheter is navigated into the superior sagittal sinus and then used to measure ipsilateral venous pressures across the site of outflow obstruction (this will be the time point where the study intervention will be performed).
End-tidal carbon dioxide concentrations will be adjusted to fall in the End-tidal carbon dioxide concentrations will be adjusted to fall in the 38-40 mmHg range
Wake Forest University Health Sciences
Winston-Salem, North Carolina, United States
Venous Sinus Pressures
Time frame: Baseline
Venous Sinus Pressures
Time frame: After intervention, up to 5 minutes
Venous Sinus Diameter
Time frame: Baseline
Venous Sinus Diameter
Time frame: After Intervention, up to 5 minutes
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Mean arterial pressure will be adjusted to fall in the 100-110 mmHg range
Mean arterial pressure will be adjusted to fall in the 60-80 mmHg range
End-tidal carbon dioxide concentrations will be adjusted to fall in the 24-26 mmHg range