Hyperperfusion Syndrome After Stenting for Intracranial Artery Stenosis

Hyperperfusion syndrome (HPS) is a rare but potentially devastating postoperative complication developing after endarterectomy and carotid stenting. Limited information is available about this complication. The aim of this study was to assess the incidence of HPS and risk factors leading to its deve...

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Bibliographic Details
Published in:Cell biochemistry and biophysics 2015-04, Vol.71 (3), p.1537-1542
Main Authors: Xu, Shancai, Wu, Pei, Shi, Huaizhang, Ji, Zhiyong, Dai, Jiaxing
Format: Article
Language:English
Subjects:
Arteries - surgery
Biochemistry
Biological and Medical Physics
Biomedical and Life Sciences
Biophysics
Biotechnology
Blood pressure
Cell Biology
Cerebral Revascularization - adverse effects
Constriction, Pathologic - surgery
Female
Humans
Hypertension
Life Sciences
Male
Middle Aged
Original Paper
Pharmacology/Toxicology
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Postoperative Complications - therapy
Retrospective Studies
Risk factors
Stents - adverse effects
Citations: Items that this one cites
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Summary:Hyperperfusion syndrome (HPS) is a rare but potentially devastating postoperative complication developing after endarterectomy and carotid stenting. Limited information is available about this complication. The aim of this study was to assess the incidence of HPS and risk factors leading to its development. We retrospectively reviewed 178 consecutive cases of patients who underwent stenting of intracranial artery revascularization. We analyzed the association between HPS and patient’s age, collateral vascular supply of the lesion, the interval between operation and the last occurrence of ischemic symptom, adequacy of blood pressure control after the operation, and other risk factors such as diabetes, smoking, hypertension, and gender. Of 178 included patients, we found HPS in six cases (3.4 %). Failure to strictly control postoperative blood pressure, a less than 3-week long interval between operation and the last occurrence of ischemic symptom, and poor collateral circulation were significantly associated with the development of HPS. The aforementioned factors are predictors for HPS. We argue that nitroprusside should not be used to control blood pressure after the operation because its use permits considerable blood pressure fluctuations.
ISSN:1085-9195
1559-0283
DOI:10.1007/s12013-014-0377-7