Cerebral Hyperperfusion Syndrome after Percutaneous Transluminal Stenting of the Craniocervical Arteries

Meyers, Philip M.; Higashida, Randall T.; Phatouros, Constantine C.; Malek, Adel M.; Lempert, Todd E.; Dowd, Christopher F.; Halbach, Van V.

doi:10.1097/00006123-200008000-00013

Cited by 201 publications

(141 citation statements)

References 58 publications

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“…In carotid stenting series for stenotic disease, hyperperfusion was relatively rare, occurring in 5% to 7% of carotid stenting cases. 17,18 It is possible that the limited number of patients presented herein precluded the detection of such a complication.…”

Section: Reduction Of Long-term Risk Of Ischemic Eventsmentioning

confidence: 98%

Emergent Stenting of Extracranial Internal Carotid Artery Occlusion in Acute Stroke Has a High Revascularization Rate

Jovin

Gupta

Uchino

et al. 2005

Stroke

169

136

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Background and Purpose-Acute ischemic stroke attributable to extracranial internal carotid artery (ICA) occlusion is frequently associated with severe disability or death. In selected cases, revascularization with carotid artery stenting has been reported, but the safety, recanalization rate, and clinical outcomes in consecutive case series are not known. Methods-We retrospectively reviewed all of the cases of ICA occlusions that underwent cerebral angiography with the intent to revascularize over a 38-month period. Two groups were identified: (1) patients who presented with an acute clinical presentation within 6 hours of symptom onset (nϭ15); and (2) patients who presented subacutely with neurologic fluctuations because of the ICA occlusion (nϭ10). Results-Twenty-five patients with a mean age of 62Ϯ11 years and median National Institutes of Health Stroke Scale (NIHSS) of 14 were identified. Twenty-three of the 25 patients (92%) were successfully revascularized with carotid artery stenting. Patients in group 1 were younger and more likely to have a tandem occlusion and higher baseline NIHSS when compared with group 2. Patients in group 2 were more likely to show early clinical improvement defined as a reduction of their NIHSS by Ն4 points and a modified Rankin Score of Յ2 at 30-day follow-up. Two clinically insignificant adverse events were noted: 1 asymptomatic hemorrhage and 1 nonflow-limiting dissection. Conclusions-Endovascular treatment of acute ICA occlusion appears to have a high-recanalization rate and be relatively safe in our cohort of patients with acute ICA occlusion. Future prospective studies are necessary to determine which patients are most likely to benefit from this form of therapy.

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Section: Reduction Of Long-term Risk Of Ischemic Eventsmentioning

confidence: 98%

Emergent Stenting of Extracranial Internal Carotid Artery Occlusion in Acute Stroke Has a High Revascularization Rate

Jovin

Gupta

Uchino

et al. 2005

Stroke

169

136

View full text Add to dashboard Cite

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“…4 Hyperperfusion syndrome has a characteristic triad (headache, seizure, and focal neurologic deficits) and typically occurs within several hours or days after the procedure. [5][6][7] Risk factors for hyperperfusion have been proposed, including high-grade stenosis, poor collateral circulation, high blood pressure, age, and bloodbrain barrier breakdown. [7][8][9][10][11] Nevertheless, the underlying pathophysiology of HPS has not been well evaluated due to its low incidence (0.7%-3%).…”

mentioning

confidence: 99%

Stenotic Transverse Sinus Predisposes to Poststenting Hyperperfusion Syndrome as Evidenced by Quantitative Analysis of Peritherapeutic Cerebral Circulation Time

Lin

Chang

Tsai

et al. 2014

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:Hyperperfusion syndrome is a devastating complication of carotid stent placement. The shortening of cerebral circulation time after stent placement is seen as a good indicator of the development of hyperperfusion syndrome. The purpose of our study was to evaluate whether patients with ipsilateral transverse sinus stenosis are prone to having shortened cerebral circulation time after stent placement, subsequently leading to the possible development of hyperperfusion syndrome.

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“…Meyers et al documented a 5% incidence of hyperperfusion syndrome following carotid angioplasty and stenting in a group of 140 cases. 5 The incidence of intraparenchymal cerebral hematoma is 3.8% following carotid stenting. 6 No clinical manifestations in the external carotid artery territory are reported, possibly because of the higher location of the stenting.…”

Section: Discussionmentioning

confidence: 99%

Reversible Rapid Neck Swelling Following Carotid Artery Stenting: A Case Report

Keshava

Mammen

Stephen

et al. 2017

J Clin Interv Radiol ISVIR

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We report a case of rapid neck swelling from diffuse enlargement of the parotid gland that developed following stenting of the common carotid artery for significant stenosis in a postradiation scenario. Hyperperfusion was considered as the possible mechanism. The pathology and differential diagnoses are discussed. It was conservatively managed and there was significant reduction in the swelling within three days.

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Cerebral Hyperperfusion Syndrome after Percutaneous Transluminal Stenting of the Craniocervical Arteries

Cited by 201 publications

References 58 publications

Emergent Stenting of Extracranial Internal Carotid Artery Occlusion in Acute Stroke Has a High Revascularization Rate

Emergent Stenting of Extracranial Internal Carotid Artery Occlusion in Acute Stroke Has a High Revascularization Rate

Stenotic Transverse Sinus Predisposes to Poststenting Hyperperfusion Syndrome as Evidenced by Quantitative Analysis of Peritherapeutic Cerebral Circulation Time

Reversible Rapid Neck Swelling Following Carotid Artery Stenting: A Case Report

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