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Intraprocedural Prediction of Hemorrhagic Cerebral Hyperperfusion Syndrome After Carotid Artery Stenting.
MedLine Citation:
PMID:  22209646     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Hyperperfusion syndrome (HPS) is a rare but severe complication after carotid artery stenting (CAS). Reliable methods for predicting HPS remain to be developed. We aimed to establish a predictive value of hemorrhagic HPS after CAS. Our retrospective study included 136 consecutive patients who had undergone CAS. We determined the cerebral circulation time (CCT) by measuring the interval between the point of maximal opacification of the terminal portion of the internal carotid artery and the cortical vein. We calculated intraprocedural CCT changes (ΔCCT) by subtracting postprocedural CCT values from preprocedural CCT values. The mean ΔCCT was 0.9 ± 0.9 seconds; 3 patients (2.2%) with prolonged ΔCCT (2.7, 5.4, and 5.8 seconds) developed HPS. The cutoff time of 2.7 seconds predicted hemorrhagic HPS retrospectively with 100% sensitivity and 99% specificity. Our findings suggest that post-CAS HPS can be predicted by using the ΔCCT value obtained by intraprocedural digital subtraction angiography. Patients with a ΔCCT >2.7 seconds require careful intensive hemodynamic and neurologic monitoring after CAS.
Authors:
Sumito Narita; Hiroshi Aikawa; Shun-Ichi Nagata; Masanori Tsutsumi; Kouhei Nii; Hidenori Yoshida; Yoshihisa Matsumoto; Shuko Hamaguchi; Hosei Etoh; Kimiya Sakamoto; Ritsuro Inoue; Kiyoshi Kazekawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-28
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  -     ISSN:  1532-8511     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-1-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
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