Risk assessment of hyperperfusion induced intracranial hemorrhage after stenting in patients with severe carotid stenosis
10.3969/j.issn.1672-5921.2017.09.003
- VernacularTitle:症状性颈动脉重度狭窄患者支架术后高灌注脑出血的风险评估
- Author:
Yunhai DI
1
;
Lei ZHANG
;
Dongwei DAI
;
Bo HONG
;
Qinghai HUANG
;
Yi XU
;
Jianmin LIU
Author Information
1. 第二军医大学附属长海医院神经外科
- Keywords:
Carotid disease;
Stent implantation;
Intracranial hemorrhage;
Risk factor;
Hyperperfusion syndrome
- From:
Chinese Journal of Cerebrovascular Diseases
2017;14(11):571-575
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the risk of hyperperfusion induced intracranial hemorrhage (HICH) after carotid artery stenting (CAS) in patients with symptomatic severe carotid stenosis.Methods From June 2009 to June 2015,the clinical data of 210 patients with symptomatic severe carotid stenosis (70％-99％) treated with CAS at Department of Neurosurgery,Changhai Hospital,the Second Military Medical University,were analyzed retrospectively.Seven of them (3.3 ％) developed HICH after operation.The relationship between the clinical baseline and imaging characteristics and HICH were assessed.All patients received the evaluation of cerebral CT perfusion examination.The time to peak (TTP) index of cerebral blood flow was defined as the TTP ratio of the affected and contralateral sides,t test was used to conduct the comparison of measurement data,and Poisson test was used to conduct the comparison of the enumeration data.Results There was significant difference in the TTP index between the HICH group and non-HICH group (1.15 ± 0.10 vs.1.30 ± 0.15,t =4.461,P ＜ 0.01).The receiver operating characteristic (ROC)curve analysis results suggested that the TTP index ＞ 1.22 could be used as a risk factor for predicting HICH (sensitivity 100％,specificity 75.9％).Conclusion Under the condition of prompting the preoperative TTP index ＞ 1.22,the risk of HICH may be higher after CAS in patients with severe carotid stenosis.
