Prediction of cerebral hyperperfusion syndrome after carotid artery stenting by CT perfusion imaging with acetazolamide challenge

Yoshie, Tomohide; Ueda, Toshihiro; Takada, Tatsuro; Nogoshi, Shinji; Fukano, Takayuki; Hasegawa, Yasuhiro

doi:10.1007/s00234-015-1623-4

Cited by 26 publications

(28 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Table 1 shows that when comparing CEA and CAS, the frequency of ICH in the context of CHS in large studies was higher after CAS, ranging from 0.28% to 4.05%. (1, 7,9,19,30,39,42,47,49,55,57,65) In CEA varied from 0% to 2.15%. (2,5,9,10,13,16,18,20,23,29,34,(43)(44)(45), 47, 61) Also, 73% of the studies involving CAS had a frequency of ICH in the context of CHS above 0.5%.…”

Section: 2-study Characteristicsmentioning

confidence: 98%

“…(2,5,9,10,13,16,18,20,23,29,34,(43)(44)(45), 47, 61) Also, 73% of the studies involving CAS had a frequency of ICH in the context of CHS above 0.5%. (1, 7,9,19,30,39,42,47,49,55,57,65) In CEA, these frequencies occurred in only 26% of the cases. (2, 5, 9, 10, 13, 16, 18, 20, 23, 29, 34, 43-45, 47, 61) The "ICH to CHS proportion" has higher after CAS in comparison to CES: 7 out of 11 CAS studies (63.6%) had 50% or more hemorrhagic CHS (range 0-100%).…”

Section: 2-study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Intracerebral hemorrhage as a manifestation of cerebral hyperperfusion syndrome after carotid revascularization: systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: 2-study Characteristicsmentioning

confidence: 98%

Section: 2-study Characteristicsmentioning

confidence: 99%

Intracerebral hemorrhage as a manifestation of cerebral hyperperfusion syndrome after carotid revascularization: systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…These studies echo other earlier studies that suggested mean transit time to be more sensitive than cerebral blood flow and cerebral blood volume for identifying haemodynamic compromise. 13 Prevention strategies for CHS include stringent blood pressure control in the early postoperative period, and performing staged angioplasty and stenting procedures in those at higher risk of developing CHS. 6,14…”

Section: Discussionmentioning

confidence: 99%

Delayed Cerebral Hyperperfusion with Subarachnoid Haemorrhage after Carotid Artery Stenting

Tse¹,

Ho²,

Tsang³

et al. 2018

Hong Kong J Radiol

View full text Add to dashboard Cite

Cerebral hyperperfusion syndrome is a rare but serious complication after carotid revascularisation procedures that manifests as ipsilateral migraine-like headache, seizure, and transient focal neurological deficits in the absence of cerebral ischaemia. Cerebral hyperperfusion syndrome may lead to cerebral oedema and haemorrhage, and imaging findings of hyperperfusion may be seen. Cerebral hyperperfusion syndrome and haemorrhage after carotid artery stenting occurs most often in the first postoperative day and rarely after the first week. We report a case of a patient with delayed subarachnoid haemorrhage 16 days after carotid artery stenting, presenting with headache and focal neurological deficit, with associated imaging findings of hyperperfusion. Given the short hospital stays associated with carotid artery stenting, the present case highlights the need for vigilance by patients, carers, and clinicians for this serious complication.

show abstract

“…Xe-CT can quantitatively display cerebral perfusion with convenient inspection, on the basis of routine CT examinations, fast evaluation of CBF and vascular reserve capacity, especially after stent implantation. Quantitative detection of cerebral arterial blood flow can be an effective method for diagnosis of high perfusion comprehensive syndrome of patients and improvement after operation to provide the basis for the judgment of prognosis of patients and reduce ISR (14,15). …”

Section: Discussionmentioning

confidence: 99%

Correlation between high perfusion syndrome and stent restenosis after stent implantation

Tang

Dong

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

The present study was conducted to determine the correlation between high perfusion syndrome and stent restenosis after cerebral vascular stent implantation. A total of 146 patients diagnosed with cerebral vascular stenosis and stent implantation were selected. A total of 55 cases (37.67%) of cerebral hyperperfusion syndrome patients were diagnosed by xenon-enhanced computer tomography (Xe-CT) examination and clinical symptoms within 3 days after surgery and were chosen as the observation group. A total of 91 cases were selected as the control group. After treatment, blood flow of the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, anterior border zone, posterior border zone and the inner border zone of the two groups increased, with values in the observation group increasing more significantly, and the differences were statistically significant (P<0.05). The rate of restenosis and target lesion diameter one month and one year after operation in the observation group were significantly higher than those in the control group (P<0.05). Multivariate logistic regression analysis showed that the mean systolic blood pressure (mSBP), mean diastolic blood pressure (mDBP), stenosis rate of cerebral vascular diameter and high perfusion syndrome were independent risk factors for restenosis (P<0.05). The application of Xe-CT examination is important for early diagnosis of hyperperfusion syndrome. Hyperperfusion syndrome and the occurrence of stent restenosis are closely related. mSBP, mDBP, cerebral blood vessel diameter stenosis rate and high perfusion comprehensive syndrome are the independent risk factors of restenosis.

show abstract

Prediction of cerebral hyperperfusion syndrome after carotid artery stenting by CT perfusion imaging with acetazolamide challenge

Abstract: Pretreatment CTP with acetazolamide challenge could identify patients at risk for HPS after CAS. Although the CTP parameter that most accurately identified patients at risk for HPS was the absolute value of post-acetazolamide MTT, resting MTT was sufficiently accurate.

Cited by 26 publications

References 17 publications

Intracerebral hemorrhage as a manifestation of cerebral hyperperfusion syndrome after carotid revascularization: systematic review and meta-analysis

Intracerebral hemorrhage as a manifestation of cerebral hyperperfusion syndrome after carotid revascularization: systematic review and meta-analysis

Delayed Cerebral Hyperperfusion with Subarachnoid Haemorrhage after Carotid Artery Stenting

Correlation between high perfusion syndrome and stent restenosis after stent implantation

Contact Info

Product

Resources

About