Cerebral Hyperperfusion After Carotid Stenting: A Transcranial Doppler and SPECT Study

Sfyroeras, George S.; Karkos, Christos D.; Arsos, Georgios; Liasidis, Charalampos; Dimitriadis, A; Papazoglou, Konstantinos; Gerassimidis, Thomas S.

doi:10.1177/1538574408324510

Cited by 24 publications

(9 citation statements)

References 21 publications

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“…However Sfyroeras et al did not find an association between preoperative asymmetry in brain perfusion in rest and CHS. 68 Ogasawara et al suggested that hyperperfusion lasting at least to the three postoperative days on SPECT predisposes to CHS development. 69 Advanced imaging processes and statistical analyses can further improve the predictive value of this technique.…”

Section: Investigatory Techniques In Prediction and Diagnosis Of Chsmentioning

confidence: 99%

Hyperperfusion syndrome after carotid revascularization

Moulakakis

Mylonas

Sfyroeras

et al. 2009

Journal of Vascular Surgery

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229

166

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Cerebral hyperperfusion syndrome is a rare, serious complication of carotid revascularization either after carotid endarterectomy or carotid stent placement. Impaired cerebral autoregulation and post-revascularization changes in cerebral hemodynamics are the main mechanisms involved in the development of the syndrome. Hyperperfusion syndrome may be fatal once an intracranial hemorrhage occurs. This article reviews the literature, intending to make a synthesis of all new data concerning the clinical manifestations of hyperperfusion syndrome, the pathophysiologic pathways involved in its development, the prediction, and the appropriate management. Also, a review of the most recent series of hyperperfusion syndrome following carotid revascularization, both with classic open endarterectomy and carotid artery stenting has been performed.

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Section: Investigatory Techniques In Prediction and Diagnosis Of Chsmentioning

confidence: 99%

Hyperperfusion syndrome after carotid revascularization

Moulakakis

Mylonas

Sfyroeras

et al. 2009

Journal of Vascular Surgery

Self Cite

229

166

View full text Add to dashboard Cite

show abstract

“…This finding is probably due to an improvement in vasodilatory ability, indicating return of vascular reserve capacity. Although such patients may benefit from greater hemodynamic improvements, hyperperfusion is still a concern that can lead to hemorrhage [75]. In fact, a condition called cerebral hyperperfusion syndrome (CHS) after carotid intervention has been classically described as an acute neurologic deficit occurring from hours to days following a carotid procedure and represents a spectrum of clinical symptoms ranging from severe unilateral headache, to seizures and focal neurologic defects, to intracerebral hemorrhage in its most severe form.…”

Section: Cvr Mapping With Boldmentioning

confidence: 99%

Assessing Cerebrovascular Reactivity in Carotid Steno-Occlusive Disease Using MRI BOLD and ASL Techniques

Leoni

Mazzetto-Betti

Silva

et al. 2012

Radiology Research and Practice

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Impaired cerebrovascular reactivity (CVR), a predictive factor of imminent stroke, has been shown to be associated with carotid steno-occlusive disease. Magnetic resonance imaging (MRI) techniques, such as blood oxygenation level-dependent (BOLD) and arterial spin labeling (ASL), have emerged as promising noninvasive tools to evaluate altered CVR with whole-brain coverage, when combined with a vasoactive stimulus, such as respiratory task or injection of acetazolamide. Under normal cerebrovascular conditions, CVR has been shown to be globally and homogenously distributed between hemispheres, but with differences among cerebral regions. Such differences can be explained by anatomical specificities and different biochemical mechanisms responsible for vascular regulation. In patients with carotid steno-occlusive disease, studies have shown that MRI techniques can detect impaired CVR in brain tissue supplied by the affected artery. Moreover, resulting CVR estimations have been well correlated to those obtained with more established techniques, indicating that BOLD and ASL are robust and reliable methods to assess CVR in patients with cerebrovascular diseases. Therefore, the present paper aims to review recent studies which use BOLD and ASL to evaluate CVR, in healthy individuals and in patients with carotid steno-occlusive disease, providing a source of information regarding the obtained results and the methodological difficulties.

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“…TCD has, in fact, been proven useful in the prediction of these complications. 40,41 Computed tomography and magnetic resonance angiography. With the increasing utilization of noninvasive imaging studies such as CTA and MRA prior to carotid interventions, standardization of the reporting of imaging findings is necessary.…”

Section: Diagnostic Imaging Studiesmentioning

confidence: 99%

Reporting standards for carotid interventions from the Society for Vascular Surgery

Timaran

McKinsey

Schneider

et al. 2011

Journal of Vascular Surgery

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Cerebral Hyperperfusion After Carotid Stenting: A Transcranial Doppler and SPECT Study

Abstract: Symptomatic cerebral hyperperfusion is not uncommon after carotid stenting. There seems to be a link between exhausted cerebrovascular reactivity of the ipsilateral middle cerebral artery and increased risk of cerebral hyperperfusion.

Cited by 24 publications

References 21 publications

Hyperperfusion syndrome after carotid revascularization

Hyperperfusion syndrome after carotid revascularization

Assessing Cerebrovascular Reactivity in Carotid Steno-Occlusive Disease Using MRI BOLD and ASL Techniques

Reporting standards for carotid interventions from the Society for Vascular Surgery

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