Near-infrared spectroscopy in carotid artery stenting predicts cerebral hyperperfusion syndrome

Matsumoto, Shoji; Nakahara, Ichirō; Higashi, Tatsuya; Iwamuro, Yasushi; Watanabe, Yoshihiko; Takahashi, Kou; Ando, Mitsushige; Takezawa, Masahiro; Kira, Jun‐ichi

doi:10.1212/wnl.0b013e3181a2e846

Cited by 61 publications

(33 citation statements)

References 30 publications

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“…The rSO 2 was slightly higher than on the opposite side immediately after recanalization because of reperfusion of the occluded carotid artery. Post-stenting hyperperfusion syndrome is reported to occur frequently if the rSO 2 is 10% or more higher than the baseline value 3 minutes after recanalization, 5) but the increase was less than 10% in both our patients, and hyperperfusion syndrome was not observed in either patient.…”

Section: Disclosure Statementcontrasting

confidence: 54%

Emergency Retrograde Left Common Carotid Artery Stenting after Thoracic Endovascular Aortic Repair with Regional Cerebral Oxygen Saturation Monitoring: Report of Two Cases

Kikuchi

Ando

Nakazawa

et al. 2018

JNET

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Objective: Two cases in which emergency retrograde stenting were performed for occlusion of the left common carotid artery orifice that occurred during thoracic endovascular aortic repair are reported. Case Presentations:In males in their 70s with thoracic aortic aneurysm, oxygen saturation dropped in the left cerebrum immediately after deployment of the thoracic aortic stent graft under general anesthesia. The stent graft obstructed the orifice of the left common carotid artery, and recanalization was achieved by direct puncture of the cervical left common carotid artery and placing a balloon expandable stent at the orifice of the left common carotid artery. No postprocedural neurologic deficits were observed. Conclusion:Retrograde stenting of the orifice of the left common carotid artery is effective for thoracic aortic stent graft migration, and regional cerebral oxygen saturation is an important index. The cases are worth reporting as neurointerventionist may also be required to perform the procedure, which is usually performed by vascular surgeons.

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Section: Disclosure Statementcontrasting

confidence: 54%

Emergency Retrograde Left Common Carotid Artery Stenting after Thoracic Endovascular Aortic Repair with Regional Cerebral Oxygen Saturation Monitoring: Report of Two Cases

Kikuchi

Ando

Nakazawa

et al. 2018

JNET

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“…Thus, the efficacy of NIRS, which was the second most common modality used to detect the hyperperfusion phenomenon in this study, may be promising. 27) The low penetration rate of TCD (<10%) in this study was thought to reflect the fact that most of the Japanese neurointerventionalists were neurosurgeons 8) and that insonation through the temporal bone window was limited in elderly Asian (Japanese) people. 28) There were two institutes that performed the X-ray angiography perfusion analysis using the application that was bundled with their angiography equipment.…”

Section: Resultsmentioning

confidence: 82%

Periprocedural Evaluation and Management against Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting in Japan: A Nationwide Questionnaire Survey

Hayakawa

Matsumaru

Sakai

et al. 2017

NOUSHINKEI KEKKANNAI TIRYOU

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Objective: Cerebral hyperperfusion syndrome (CHS) including intracranial hemorrhage (ICH) is a serious complication after carotid artery stenting (CAS). Therefore, neurointerventionalists in Japan commonly stratify the risk for CHS preprocedurally in CAS candidates using various imaging tests that are available, and sometimes performed preventive methods against CHS, such as staged angioplasty (SAP), undersized-balloon angioplasty followed by delayed CAS. In the current study, we used a nationwide questionnaire survey to clarify the current status of the periprocedural management against CHS and the 30-day outcomes of patients with a high risk of CHS after undergoing CAS or endovascular carotid revascularization procedures, such as SAP or stand-alone angioplasty. This study specifically analyzed the data for the periprocedural management against CHS. Materials and Methods:Between June and August 2014, questionnaires were emailed to all of the neurointerventional specialists certified by the Japanese Society for Neuroendovascular Therapy (JSNET). If two or more specialist physicians belonged to an institute, a representative physician of the institute answered the questionnaire. This study focused on 14 items of the questionnaire that were directed at examining the preprocedural imaging tests done to evaluate the risk of CHS, the periprocedural management strategies used to prevent CHS, and the postprocedural imaging tests to detect hyperperfusion phenomenon, among others.Results: Replies were obtained from 154 institutes which represented 336 JSNET-certified neurointerventional specialists. Preprocedural imaging tests done to evaluate the risk of CHS were performed in 144 institutes (93.5%), with single-photon emission CT (SPECT) the most used modality in 88.2% of the institutes. Acetazolamide challenge was performed in 114 (89.8%) of 127 institutes that used preprocedural SPECT evaluation. Of the institutes performing preprocedural CHS-risk evaluation, general anesthesia was administered during the procedure in 44.4%, periprocedural

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“…Ogasawara et al [15] reported that HP can be detected immediately after carotid endarterectomy by SPECT, and Matsumoto et al [18] reported that the increase in CBF detected just after CAS using near-infrared spectroscopy predicts the cerebral HP syndrome. HP starts during carotid artery stenosis surgery, and we detected dynamic IC dilation due to an increase in blood flow that can induce the HP syndrome.…”

Section: Discussionmentioning

confidence: 99%

Dilation of the Internal Carotid Artery at the Entrance to the Carotid Canal following Carotid Artery Stenting Predicts Postprocedural Hyperperfusion

et al. 2013

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Objective: Ischemic stroke and hyperperfusion (HP) are the most frequent and important complications in carotid artery stenosis surgery. Carotid artery stenting (CAS) has replaced carotid endarterectomy in high medical risk patients. Prior to CAS, initial angiographic findings disclose a small caliber internal carotid artery (IC) due to stenosis, but after the stenosis is relieved, the diameter of the IC becomes enlarged. We investigated whether a change in the IC diameter was related to ischemic complication and HP using cerebral blood flow single photon emission computed tomography (SPECT). Methods: From February 2008 to December 2009 we consecutively performed 39 CAS on 35 patients. We retrospectively analyzed the relationship between changes at the level before the entry to the petrous bone canal of the IC and stenosis of the etiological artery, improvement in stenosis, HP and postintervention diffusion-weighted image high-intensity lesions. Statistical analyses comprised Wilcoxon/Kruskal-Wallis analysis, analysis of variance and a multivariate logistic analysis. Results: A total of 9 cases showed HP in SPECT. Severity of IC stenosis and change in the IC at the level before the entry to the petrous bone canal were related with statistical significance to HP. Other factors did not correlate with HP. Conclusion: Procedure-related dilation of the IC at the level before the entry to the petrous bone canal occurred due to release of the etiological stenosis. This finding can also support the prediction of HP.

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Near-infrared spectroscopy in carotid artery stenting predicts cerebral hyperperfusion syndrome

Abstract: Periprocedural increases in regional cerebral oxygen saturation measured by near- infrared spectroscopy can be an excellent predictor of cerebral hyperperfusion syndrome after carotid artery stenting.

Cited by 61 publications

References 30 publications

Emergency Retrograde Left Common Carotid Artery Stenting after Thoracic Endovascular Aortic Repair with Regional Cerebral Oxygen Saturation Monitoring: Report of Two Cases

Emergency Retrograde Left Common Carotid Artery Stenting after Thoracic Endovascular Aortic Repair with Regional Cerebral Oxygen Saturation Monitoring: Report of Two Cases

Periprocedural Evaluation and Management against Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting in Japan: A Nationwide Questionnaire Survey

Dilation of the Internal Carotid Artery at the Entrance to the Carotid Canal following Carotid Artery Stenting Predicts Postprocedural Hyperperfusion

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